Related Experiment Video
Updated: Aug 11, 2026
05:05
Ultrasound Cyclo Plasty in Eyes with Glaucoma
Published on: January 26, 2018
Ablative or non-ablative therapy for Graves' hyperthyroidism in patients with ophthalmopathy?
1Division of Clinical Sciences, Northern General Hospital, Sheffield, United Kingdom.
Journal of Endocrinological Investigation
|October 10, 1998
Summary
For hyperthyroidism with Graves' ophthalmopathy, evidence supporting surgical or radioiodine ablation is lacking. Antithyroid drugs are preferred for initial treatment due to established risks of ablation.
Area of Science:
- Endocrinology
- Ophthalmology
- Nuclear Medicine
Background:
- Hyperthyroidism, particularly Graves' disease, can be complicated by Graves' ophthalmopathy.
- Deliberate ablation using surgery or radioiodine is a treatment option for hyperthyroidism.
- The impact of ablation on Graves' ophthalmopathy remains controversial.
Purpose of the Study:
- To evaluate the evidence supporting the use of surgical or radioiodine ablation for hyperthyroidism in patients with Graves' ophthalmopathy.
- To discuss the theoretical basis and risks associated with ablation in this context.
- To provide a recommendation for the preferred initial treatment.
Main Methods:
- Review of existing controlled trials and scientific literature.
- Assessment of the theoretical underpinnings of ablation's effect on ophthalmopathy.
- Consideration of established risks and patient preferences.
Main Results:
- No properly controlled trials demonstrate a beneficial effect of ablation on ophthalmopathy.
- The theoretical basis for ablation's benefit is questionable.
- Established risks are associated with ablation procedures.
Conclusions:
- Ablation is not routinely recommended for hyperthyroidism in the presence of Graves' ophthalmopathy.
- Antithyroid drugs are the preferred initial treatment.
- Individualized treatment is advised for recurrent hyperthyroidism based on patient preference.
Related Concept Videos
01:25Glaucoma: Overview
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
01:27Open Angle Glaucoma: Treatment
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:28Angle Closure Glaucoma: Treatment
Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
01:23Ophthalmic Drug Delivery Systems
Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...
01:24Graves Disease II: Pathophysiology
Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...