Use of intravenous dexamethasone for thyroid exophthalmopathy
Journal Title: IP International Journal of Ocular Oncology and Oculoplasty - Year 2016, Vol 2, Issue 3
Abstract
Thyroid eye disease (TED) often termed as Graves ophthalmopathy, is a part of an autoimmune process that can affect the orbital and periorbital tissue associated with abnormality of thyroid gland.1 The condition primarily affects women and has an incidence of approximately 4/10,000 per annum. Thyroid ophthalmopathy is the commonest cause of unilateral and bilateral axial proptosis in young and middle aged adults. TED is commonly associated with hyperthyroidism (90%) and in few cases patients are euthyroid (6%).2 Smoking is associated with an increased risk of development and severity of thyroid eye disease by 7-8 fold.3,4,5 With increasing awareness of thyroid eye disease more cases of mild to severe grades of thyroid eye disease are being diagnosed and treated. TED is an autoimmune disorder commonly associated with ophthalmopathy, characterized by periorbital edema, unilateral or bilateral proptosis, extra-ocular muscle dysfunction, keratitis and optic nerve compression. Pathogenesis of Graves' ophthalmopathy is related to autoimmune reactions directed to orbital antigens, in particular to eye muscle68 and accumulation of glycosa-aminoglycans. On the basis of the immunological mechanisms producing the inflammatory changes in the orbit, attempts have been made to control the immunological reactions of glycosa-aminoglycans with immune-suppressive drugs such as corticosteroids9 , cyclophosphamide10 and cyclosporin A11-13 and with plasma exchange14 for the treatment of glycosa-aminoglycans or its prevention15
Authors and Affiliations
Prakash Chand Agarwal
Keywords
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