Graves' orbitopathy (ophthalmopathy, GO) is an autoimmune disease of the retroorbital tissues. This topic review will provide an overview of the treatment of this disorder; its pathogenesis and clinical features are discussed separately. (See "Pathogenesis and clinical features of Graves' ophthalmopathy (orbitopathy)".)
The natural history of Graves' orbitopathy is variable and must be considered in the context of concomitant antithyroid therapy. In some patients, as an example, orbitopathy changes little for many years. In others, it may worsen or improve, or, in a few patients, follow a course characterized by exacerbations and remissions. These variations make it especially difficult to reach conclusions about the efficacy of treatment .
One study, as an example, evaluated 59 patients with untreated eye disease who had not received any immunosuppressive or surgical treatment . They had all received an antithyroid drug, which may be immunosuppressive [3,4]. As assessed using a well-characterized activity index, 66 percent of these patients improved during the first 12 months, and only 8 percent had deterioration in their eye disease.
Treatment of patients with Graves' orbitopathy has three components:
●Reversal of hyperthyroidism, if present