This book offers ophthalmologists and medical practitioners a concise, data-driven review of the information that is most relevant in guiding the diagnosis and management of thyroid-associated eye diseases (TED). Particular attention is devoted to research and clinical trials that have advanced the field in recent years.
Progress in our understanding of the pathogenesis of TED is described, and the heterogeneous natural history of TED is discussed to facilitate preemptive interventions. Advances in diagnostic evaluation, including autoantibody assessment, are reviewed with regard to their clinical utility. The diagnostic features of euthyroid TED are also carefully covered since these patients often represent a diagnostic dilemma.
All relevant aspects of treatment are addressed including the role of radioactive iodine, long-term medical therapy, and surgical thyroidectomy. The impact of these treatment modalities on eye disease are discussed. Management of active TED is reviewed according to the severity of disease and in the light of recent findings and the introduction of novel agents. The discussion encompasses the role of steroids and other agents, the use of novel biologics, the medical and surgical treatment of optic neuropathy, and minimally invasive, customized reconstructive surgery. Numerous supporting images are included, and helpful checklists will aid the practitioner in treatment decision making.
Table of Contents
Chapter 1 Diagnosis and Endocrine Management of Graves’ Disease
George J. Kahaly
Chapter 2 Natural History of Thyroid Eye Disease
Peter J. Dolman
Chapter 3 Emerging Role of Fibrocytes in the Pathogenesis of Thyroid Eye Disease
Terry J. Smith
Chapter 4 Management of Hyperthyroidism and the Effects on Thyroid Eye Disease
Fatemeh Rajaii, Shivani Gupta, and Raymond S. Douglas
Chapter 5 Smoking and Prevention of Thyroid Eye Disease
Wilmar M. Wiersinga
Chapter 6 Nutrition and Supplements in Thyroid Eye Disease
Claudio Marcocci and Francesca Menconi
Chapter 7 Pregnancy and Childhood Thyroid Eye Disease
Andrew G. Gianoukakis, Teeraun Jirajariyavej, Rebecca A. Hicks, Jennifer K. Yee
Chapter 8 Medical Management of Mild and Moderate to Severe Thyroid Eye Disease
Lucy Clarke and Petros Perros
Chapter 9 Management of Severe Thyroid Eye Disease and Use of Biological Agents
Mario Salvi, Richard L. Scawn, Roman Farjardo, Bobby S. Korn, Don O. Kikkawa
Chapter 10 Strabismus in Thyroid Eye Disease
Bokkwan Jun and Prem S. Subramanian
Chapter 11 Customized Minimally Invasive Orbital Decompression for Thyroid
Shivani Gupta, Allison N. McCoy, and Raymond S. Douglas
Chapter 12 Non-Invasive, Minimally Invasive and Surgical Pearls for Cosmetic
Rejuvenation of the Thyroid Eye Disease Patient
Robert Goldberg and Daniel B. Rootman
Chapter 13 Psychological Disturbances in Thyroid Eye Disease
Sally Liu Baxter, Richard L. Scawn, Bobby S. Korn, Don O. Kikkawa
Raymond S. Douglas, MD, PhD, studied at the University of Pennsylvania and
subsequently completed his residency in ophthalmology at the Scheie Eye Institute,
University of Pennsylvania and his fellowship in orbital facial plastic and
reconstructive surgery at the Jules Stein Eye Institute, University of California,
Los Angeles. He is currently Associate Professor of Ophthalmology and Visual
Sciences and a specialist in eye plastic, orbital, and facial cosmetic Surgery
at the University of Michigan, Kellogg Eye Institute. Dr. Douglas’ particular
interests include orbital surgery, especially minimally invasive surgery, and
decompressions for thyroid-associated eye disease; cosmetic facial surgery;
and post-cancer reconstruction, including Mohs surgery.
Allison N. McCoy, MD, PhD, undertook her medical training at Duke University, Durham, North Carolina and also gained a doctorate in Neurobiology from the same university. Between 2008 and 2011 she served an Ophthalmology Residency at the Wilmer Eye Institute, Baltimore, and she is currently a Fellow in Eye Plastic, Orbital, and Facial Cosmetic Surgery. Dr. McCoy has been involved in a number of research projects and has been the recipient of the Neil Miller Research Grant Award, the Michael Boland Research Grant Award, the
Mitchell Prize for Resident Research, and a Heed Fellowship. She is the author of 15 peer-reviewed publications.
Shivani Gupta, MD, MPH is an Eye Plastic, Orbital and Facial Cosmetic Surgery Lecturer in the Department of Ophthalmology and Visual Sciences at the University of Michigan. Her special interests include orbital surgery, cosmetic facial surgery including fillers and Botox injections, eyelid and lacrimal disorders, post-cancer reconstruction including Mohs' surgery.