GRAVES OPHTHALMOPATHY - PATHOGENESIS, DIA GNOSIS AND THERAPY

Graves' ophthalmopathy (GO) represents the most common extrathyroidal manifestations of Graves' disease. Recently, several important molecul ar and biochemical details concerning both cellular and humoral mechan isms in the pathogenesis of GO have been elucidated. Clinically, the o rbital manifestations of Graves' disease derive mainly from the mechan ical complications caused by expansion of the connective, adipose and muscle tissue compartments within the confines of the bony orbits. Dia gnosis of GO by a detailed history, clinical examination of the patien t, and detection of hyperthyroidism or thyroid dysregulation, is usual ly straightforward. Imaging of the orbital contents by ultrasonography , computed tomography or magnetic resonance imaging is rarely required , but should be performed to rule out important differential diagnoses or in patients with complicated GO. Whenever possible, management of patients with GO should be interdisciplinary (primary care, endocrinol ogy, ophthalmology, radiation therapy), tailored to the individual nee ds to the patient, and include a careful and long-term follow-up.