OPHTHALMOPATHY IN GRAVES' DISEASE: A COMPREHENSIVE REVIEW (Atena Editora)

Abstract

In a recent comprehensive review of Graves' disease, the study focused on ophthalmopathy as a distinctive clinical manifestation, shedding light on its complex pathophysiology, clinical implications, and management strategies. Ophthalmopathy in Graves' disease is characterized by autoimmune inflammatory processes affecting the orbital tissues, resulting in a spectrum of ocular manifestations such as proptosis, lid retraction, periorbital edema, and extraocular muscle dysfunction. The severity of Graves' ophthalmopathy can vary widely, impacting the quality of life for affected individuals. The study elucidated the underlying mechanisms, emphasizing the role of autoantibodies, particularly thyrotropin receptor antibodies (TRAb), and their interaction with the thyrotropin receptor and insulin-like growth factor 1 receptor, triggering inflammation, adipogenesis, and fibrosis within the orbital tissues. The investigation revealed intriguing correlations between clinical features and patient demographics, with a higher prevalence of severe ophthalmopathy in females over 40 and a positive association with smoking. Laboratory analyses demonstrated elevated levels of TRAb and interleukin-6 in patients with more severe ophthalmopathy, suggesting potential biomarkers for disease severity prediction. Additionally, the study assessed the impact on the quality of life, revealing significantly lower scores in patients with severe ophthalmopathy, highlighting the substantial burden of the disease on daily functioning and emotional well-being. Treatment outcomes varied among patients subjected to different modalities, including corticosteroids, orbital radiotherapy, and biologics targeting specific cytokines. While corticosteroids effectively mitigated inflammation, long-term outcomes were variable, necessitating further investigation. The study acknowledged its limitations, emphasizing the need for prospective, multicenter studies with larger cohorts and exploring long-term outcomes and genetic predispositions to enhance our understanding and improve patient care. Overall, this detailed exploration contributes valuable insights into the clinical spectrum, associations, and treatment responses in Graves' ophthalmopathy, guiding future research directions for optimized diagnostic and therapeutic approaches.