Thyroid-Associated Orbitopathy and Biomarkers: Where We Are and What We Can Hope for the Future.

Thyroid-associated orbitopathy (TAO) is the most common autoimmune disease of the orbit. It occurs more often in patients presenting with hyperthyroidism, characteristic of Graves' disease, but may be associated with hypothyroidism or euthyroidism. The diagnosis of TAO is based on clinical orbital features, radiological criteria, and the potential association with thyroid disease. To date, there is no specific marker of the orbital disease, making the early diagnosis difficult, especially if the orbital involvement precedes the thyroid dysfunction. The goal of this review is to present the disease and combine the available data in the literature concerning investigation of TAO biomarkers. Despite the progress done in the understanding of TAO disease, some important pieces are still missing. Typically, for the future, major efforts have to be done in the discovery of new biomarkers, validation of the suspected candidates on multicenter cohorts with standardized methodologies, and establishment of their clinical performances on the specific clinical application fields in order to improve not only the management of the TAO patients but also the therapeutic options and follow-up

Ophtalmologie orbitopathie dysthyroïdienne: du diagnostic au traitement

Mild to moderate forms of orbitopathy are common in auto-immune thyroid diseases, whereas severe forms are rare. Euthyroidism restoration, no smoking, and ocular local lubricants are necessary for all the patients. In case of mild orbitopathy, treatment by selenium is now indicated. Active forms of thyroid orbitopathy are better treated by IV steroids. Surgery is indicated in optic neuropathy resistant to steroids and in sequellar forms of the disease

Different locations of dermoid cysts in the orbital region.

BACKGROUND: Dermoid cysts are frequent unilateral congenital benign tumors that can be found at different locations throughout the body. In the orbital region, dermoid cysts occur predominantly in the supero-temporal quadrant. However, different orbital locations are possible, making this entity an important differential diagnosis for orbital tumors. PATIENTS AND METHODS: We retrospectively reviewed the charts of 23 consecutive patients operated in our institution between 2005 and 2014 for orbital tumors that were diagnosed as congenital dermoid or epidermoid cysts. RESULTS: There were 21 dermoid and 2 epidermoid cysts. The median age at surgery time was 7 years (range 1-41). There were 15 females and 8 males. Eleven cysts were located supero-temporally (47.8%), seven supero-medially (30.4%), two temporally (8.7%), one at the frontal bone (4.4%) and two in the fossa of the lacrimal gland (8.7%). The mean cyst diameter was 13.1 mm±5.0 (SD). None had signs of malignant disease. No recurrence was observed after complete excision. CONCLUSION: Dermoid cysts of orbital region are mostly located in the supero-temporal quadrant. However, other orbital locations are possible and dermoid cysts must thus be considered in the differential diagnosis of any mass in the orbital region

Orbitopathie bei Morbus Basedow im Kindesalter [Graves' Ophthalmopathy in a Paediatric Population]

javax.xml.bind.JAXBElement@1454aedc Graves' disease is an autoimmune disorder leading to hyperthyroidism. It is often associated with ophthalmic manifestations. Graves' disease is reported to be rare in the paediatric population. javax.xml.bind.JAXBElement@20201ad0 We performed a retrospective analysis on all patients diagnosed with ophthalmopathy related to Graves' disease at a paediatric age (less than 18 years old) in our institution between 2004 and 2015. javax.xml.bind.JAXBElement@33565fcc Eight patients were identified: 6 females and 2 males. The median age at diagnosis was 11.5 years (range 3-16). Ophthalmic signs were: proptosis (6/8), superficial punctate keratitis (5/8), eyelid retraction (4/8), lagophthalmos (2/8), and oculomotor dysfunction (2/8). No patients showed signs of complication such as ocular hypertension or compressive optic neuropathy. Orbital decompression was performed in one patient in a non-emergency setting. javax.xml.bind.JAXBElement@4bf1b257 Ophthalmic involvement in Graves' disease is rarely encountered in paediatric patients. Ophthalmologists should be aware of this entity to ensure that patients with thyroid dysfunction are identified at an early point in time