Graves’ Eye Disease: Clinical and Radiological Diagnosis

Kasen R. Hutchings, Seth J. Fritzhand, Bita Esmaeli, Kirthi Koka, Jiawei Zhao, Salmaan Ahmed, James Matthew Debnam

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Graves’ disease is an autoimmune disorder in which hyperthyroidism results in various systematic symptoms, with about 30% of patients presenting with Graves’ eye disease (GED). The majority of patients with GED develop mild symptoms, including eyelid retraction, exposure of the globe, superior rectus–levator muscle complex inflammation, and fat expansion, leading to exophthalmos. More severe cases can result in extraocular muscle enlargement, restricted ocular movement, eyelid and conjunctival edema, and compression of the optic nerve leading to compressive optic neuropathy (CON). GED severity can be classified using the Clinical Activity Score, European Group on Graves’ Orbitopathy scale, NO SPECS Classification system, and VISA system. CT and MRI aid in the diagnosis of GED through the demonstration of orbital pathology. Several recent studies have shown that MRI findings correlate with disease severity and can be used to evaluate CON. Mild cases of GED can be self-limiting, and patients often recover spontaneously within 2–5 years. When medical treatment is required, immunomodulators or radiotherapy can be used to limit immunologic damage. Surgery may be needed to improve patient comfort, preserve the orbit, and prevent vision loss from optic nerve compression or breakdown of the cornea.

Original languageEnglish (US)
Article number312
JournalBiomedicines
Volume11
Issue number2
DOIs
StatePublished - Feb 2023

Keywords

  • compressive optic neuropathy
  • extraocular muscles
  • Graves’ disease
  • Graves’ eye disease
  • lacrimal gland

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • General Biochemistry, Genetics and Molecular Biology

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