Diagnostic Approaches to and Disaese Course Modifying Therapies in Graves Orbitopathy

Abstract

Graves' Orbitopathy (GO) is an autoimmune condition that primarily affects the orbit, causing inflammation, muscle expansion, and tissue changes. Although often linked to Graves' Disease (GD), 5-10% of GO patients may not have GD at diagnosis. GO is associated with thyroid dysfunction, smoking, and genetic factors. The disease’s pathogenesis involves thyroid hormones, immune responses, and tissue alterations like glycosaminoglycan deposition and fibrosis. Diagnostic tools such as physical exams, grading systems (CAS, NOSPECS, EUGOGO, VISA), and imaging (CT, MRI, ultrasound) are critical for assessing disease severity and guiding treatment. Treatment focuses on managing thyroid dysfunction, addressing autoimmune responses, and, in advanced cases, surgical options like decompression. Despite existing therapies, there remains a need for new treatment modalities for better overall outcomes.