Thyroid and the eye.
Any thyroid cancer can metastasize to the uveal tract, even after decades; medullary thyroid cancer can be part of multiple endocrine neoplasia syndrome. Superior limbic keratoconjunctivitis and lagophthalmos are prognostic markers for more severe thyroid-associated ophthalmopathy (TAO). The restrictive ophthalmopathy of TAO may be associated with more sustained ocular hypertension and require topical therapy. Several new studies address the therapy of TAO, ranging from retrobulbar to oral to intravenous glucocorticoids, alone or combined with radiotherapy. Endonasal decompression of the posterior orbit can be done well for severe optic nerve compression; however, leaving the anterior orbital septum intact can minimize postoperative diplopia. Smoking increases the risk and relapse rate for ophthalmopathy. Thyrotropin receptor antigen on fibroblasts diffusely in the body is causative in TAO and pretibial myxedema with even increased urinary secretion of glycosaminoglycans. Corticosteroid-responsive patients show a sustained up-regulation of the Th1/Th2 profile.
Chavis
Pamela Suzanne
PS
Medical College of Virginia-VCU, PO Box 9809262, Richmond, VA 23298-0262, USA. neuro.eye1@erols.com
D019299:Decompression, Surgical / Q000009:adverse effects; D004172:Diplopia / Q000209:etiology / Q000517:prevention & control; D005938:Glucocorticoids / Q000627:therapeutic use; D006111:Graves Disease / Q000209:etiology / Q000628:therapy*; D006801:Humans; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D005938:Glucocorticoids