[Ablative therapy for immune hyperthyroidism in patients with ophthalmopathy]

Area of Science:

• Endocrinology
• Ophthalmology

Context:

• Graves' disease is an autoimmune disorder affecting the thyroid.
• Endocrine ophthalmopathy (EO) is a common complication of Graves' disease.
• The impact of ablative treatments on EO course is debated due to varied study designs.

Purpose:

• To critically evaluate the influence of different ablative treatments for Graves' disease on the progression of endocrine ophthalmopathy.
• To synthesize current evidence regarding the effects of surgical and radioiodine therapies on EO.

Summary:

• Near-total thyroid resection appears to positively influence endocrine ophthalmopathy, potentially by removing thyroid antigens.
• Radioiodine therapy for Graves' disease is associated with a negative impact on EO in up to one-third of patients.
• Concomitant glucocorticoid administration is recommended with radioiodine therapy. Early L-thyroxine supplementation post-radioiodine may be beneficial, while methimazole shows no positive effect on EO.

Impact:

• Provides a clearer understanding of treatment-related risks and benefits for patients with Graves' disease and EO.
• Informs clinical decision-making regarding the optimal management strategy for Graves' disease to mitigate EO progression.
• Highlights the need for standardized research methodologies in evaluating EO treatment outcomes.