International Journal of Medical and Health Research

International Journal of Medical and Health Research


International Journal of Medical and Health Research
International Journal of Medical and Health Research
Vol. 5, Issue 8 (2019)

Unilateral thyroid-associated ophthalmopathy as an initial presentation of euthyroid Graves’ disease


Pathik Shah, Ruchi Shah, Nisarg Shah

Unilateral exophthalmos (EO), although most frequently seen with Graves’ disease (GD), has a large differential diagnosis that includesorbital pseudo tumor, lymphoma, sarcoidosis, and IgG4-related disease. Although Graves’ ophthalmopathy (GO) is usually associated with hyperthyroidism, it has been estimated that up to 20 % of patients are euthyroid.1, 2 Thyroid Eye Disease (TED) is the most frequent extrathyroidal manifestation of Graves’ disease, and results from an increased volume of orbital tissues (connective and adipose tissue, interstitial enlargement of extraocular muscles) within the enclosed space of the bony orbits. Although excellent review articles have been published on TED, it remains a pathogenetic enigma and a therapeutic dilemma. Once initiated, the orbital immune process frequently assumes a momentum of its own, leading to non-specific but nonetheless harmful consequences such as tissue hypoxia, oxygen free radical damage, and fibrogenic tissue remodeling. Thyroid Eye Disease is a self-limiting disease with active and static phases. The initial active inflammatory phase usually lasts For 6–24 months, but may sometimes continue for several years. Exophthalmos, probably the most widely known symptom of TED, occurs in 20–30% of patients with Graves’ disease and up to 40–70% of patients with TED. In the majority of patients both eyes are equally affected, although often in an asymmetric manner. Pure unilateral ophthalmopathy is rare, with 5% to 11% of cases showing no progression to bilateral disease.
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How to cite this article:
Pathik Shah, Ruchi Shah, Nisarg Shah. Unilateral thyroid-associated ophthalmopathy as an initial presentation of euthyroid Graves’ disease. International Journal of Medical and Health Research, Volume 5, Issue 8, 2019, Pages 209-210
International Journal of Medical and Health Research