Grave’s orbitopathy – an approach to clinical evaluation and management

Abstract

Grave’s orbitopathy (GO), is a potentially sight threatening condition which constitutes a major clinical and therapeutic challenge and occurs in about 50% of patients with Grave’s disease with only 3-5% cases posing threat to sight. This autoimmune condition is mediated via cytokines secreted by T lymphocytes infiltrating in to the orbital cavity and thyrotropin receptor antibodies (TRAbs) stimulating thyrotropin receptors (TSHR). Clinical assessment for disease activity and severity in GO is important for decision making in management of both hyperthyroidism and GO. Sight threatening GO should be identified promptly and treated with high dose intravenous (IV) glucocorticoids and/or orbital decompression. Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2012; 2: 106-110 DOI: http://dx.doi.org/10.4038/sjdem.v2i2.4781