New opportunities in endocrine ophthalmopathy diagnostics (review)

Abstract

Endocrine ophthalmopathy (EOP) is a progressive autoimmune disease that affects soft retrobulbar tissues in thyroid gland diseases. The statistical data on this disease are presented. The review presents both generally accepted and alternative approaches to the diagnosis of EOP different stages. Detailed clinical symptoms, main severity and activity score classifications of EOP, the required list of physical and instrumental examinations are given. We described the diagnostic value of computed tomography, magnetic resonance imaging, optical coherence tomography, Heidelberg Retina Tomography, radioisotope studies, triplex scanning of the major vessels of the eye, the Doppler mapping method, indocyanine-green angiography, as well as the histological examination of soft retrobulbar tissues biopsy in EOP. Generally accepted diagnostic methods of EOP have their disadvantages. Therefore, nowadays the promising direction is immunological, biochemical and genetic studies of EOP activity markers. The peculiarity of these methods in EOP diagnosis is an accuracy, possibility of multiple measurements, few side effects and a relatively low cost. Further studies of key mechanisms of the development of edema, leukocyte infiltration with subsequent formation of fibrosis of extraocular muscles and retrobulbar fiber in EOP is of significance, which may improve diagnostics of clinical complicated cases and initial stages of the disease.

Keywords

• thyroid eye disease
• endocrine ophthalmopathy
• graves’ ophthalmopathy
• extraocular muscles
• retrobulbar tissue
• diagnostics