Thyroid orbitopathy: Management protocol based on review of the evidence
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Keywords

Graves ophthalmopathy
Graves’ disease
glucocorticoids
rituximab
radiotherapy

How to Cite

Gómez, C., Imitola, A., Taboada, L. B., Henao, D. C., Marín, L. F., Camargo, J., Kattath, L., Fonseca, C., Colón, C., & Ascnher, P. (2019). Thyroid orbitopathy: Management protocol based on review of the evidence. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 6(3), 210–217. https://doi.org/10.53853/encr.6.3.535

Abstract

Thyroid orbitopathy is a potentially serious condition that may threaten vision. It is the most frequent extrathyroidal manifestation of Graves’ disease and although the prevalence is not yet evaluated in our country, this complication can produce vision loss with catastrophic consequences. Taking this into account, this work was done with the objective of describing its diagnostic and therapeutic approach, based on the best available evidence.

A management protocol applicable in our context was developed. For this, an evaluation and adaptation of the European Group on Graves’ Orbitopathy (EUGOGO) 2016 guideline was done (1). For the evaluation the AGREE II tool was used (2). The GRADE methodology was used to grade the quality of evidence and to formulate recommendations. In addition, a systematic review of the literature was conducted with the objective of evaluating the efficacy of biological therapy in the management of Graves’ orbitopathy.

Throughout the document, recommendations for adequate diagnosis, treatment and follow-up are presented. The importance of having a multidisciplinary team with experience in the management of thyroid orbitopathy (endocrinology, ophthalmology, orbit surgery, radiotherapy and rheumatology) is emphasized, ideally in a third level care center. Adequate classification is essential to determine which patients will benefit from immunosuppressive therapy. If it is managed in a timely manner, a decrease in the appearance of irreversible sequelae can be achieved.

https://doi.org/10.53853/encr.6.3.535
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