What has changed in thyroid eye disease in the last five years (2020-2025)

Area of Science:

• Ophthalmology and Endocrinology
• Immunology and Molecular Medicine

Background:

• Thyroid eye disease (TED) pathogenesis involves fibrocytes expressing TSHR and IGF-1R, stimulated by orbital inflammation leading to adipogenesis.
• Understanding pathogenic mechanisms has driven progress in TED management and the development of novel therapeutics.

Purpose of the Study:

• To highlight advancements in Thyroid eye disease (TED) management, focusing on novel therapeutics and improved diagnostic approaches.
• To discuss the importance of early diagnosis and treatment in moderate-severe TED and the role of emerging technologies.

Main Methods:

• Review of randomized clinical trials validating novel therapeutics for TED.
• Investigation into the role of microbiome and potential antibiotic treatments in TED.
• Exploration of artificial intelligence and imaging for early TED diagnosis.

Main Results:

• Teprotumumab, an anti-IGF-1 receptor therapy, was FDA approved in 2020 for TED treatment.
• Emerging research suggests a role for the microbiome in thyroid autoimmunity and TED.
• Standardization of orbital and facial imaging is being studied for improved TED diagnosis.

Conclusions:

• Significant progress in TED management is attributed to understanding pathogenic mechanisms and developing targeted therapies.
• Early intervention during the progressive phase of TED is critical for treatment success.
• Artificial intelligence and advanced imaging hold promise for future TED assessment and diagnosis.