[Grave's ophthalmopathy: therapeutic strategy. Review of 30 patients].
BACKGROUND
Graves' ophthalmopathy is the primary etiology for exophthalmos in adults. It is a complex orbital disease whose pathophysiology remains controversial. Since its initial description more than 150 years ago, its heterogeneous clinical manifestations and poorly understood links with thyroid pathology remain unresolved issues. Disease activity is the main determinant for the management of Graves' ophthalmopathy, but treatments are often symptomatic, aiming at decreasing orbital inflammation.


METHODS
We report a retrospective analysis of 30 patients diagnosed with Graves' ophthalmopathy followed in our department between 1991 and 2002. Following a phase of medical management of their disease, all patients underwent surgical orbital decompression.


RESULTS
Medical and surgical care provided as well as results are presented with a mean follow-up of 23 months.


CONCLUSIONS
Based on our clinical experience, new concepts in the field of Graves' ophthalmopathy are discussed. Disease activity, evaluated through various means, appears to be the primary guide for therapeutic management. Moreover, the importance of a multidisciplinary approach is highlighted, in order to improve the management of this difficult disorder.
Boulétreau
P
P
Service de Chirurgie Maxillo-Faciale, Stomatologie, et Plastique de la Face, Centre Hospitalier Lyon-Sud, 165, Chemin du Grand Revoyet, 69495, Pierre-Bénite. pierre.bouletreau@chu-lyon.fr
Ordonnez
I
I
Orgiazzi
J
J
Breton
P
P
Freidel
M
M
D000328:Adult; D000368:Aged; D013956:Antithyroid Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D004172:Diplopia / Q000601:surgery; D005260:Female; D006111:Graves Disease / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009915:Orbit / Q000601:surgery*; D010348:Patient Care Team; D012189:Retrospective Studies
D013956:Antithyroid Agents