Thyroid-related orbitopathy

In i960 three phases found in thyroid-related orbitopathy were described the initial dynamic phase, a static phase, and a final quiescent phase. The dynamic phase results in eyelid retraction and proptosis. The static phase shows little improvement. The quiescent phase can show some improvement in eyelid retraction and ocular motility. 

There are two basic categories of thyroid-related orbitopathy infiltrative and noninfiltrative. Approximately 90% of patients have noninfiltrative disease. Noninfiltrative (class 1) thyroid-related eye disease is characterized by the mildest form of ocular involvement, with eyelid retraction but minimal proptosis. This occurs in up to 50% of patients with toxic diffuse goiter and can begin at any age, but patients tend to be yoimger, and female persons outnumber male persons in a ratio of up to 6 1. 

Graves ophthalmopathy develops in more than 80% of cases within 6 months of the diagnosis of Graves hyperthyroidism. Graves ophthalmopathy may occasionally develop before the diagnosis of hyperthyroidism. Thyroid-related orbitopathy is associated with Graves hyperthyroidism in 90% of cases and with autoimmime thyroiditis (Hashimoto s disease) in some 5%. No laboratory evidence of thyroid disease is fiaimd in 5% to 10% of patients. This condition is called ophthalmic or euthyroid Graves ophthalmopathy. 

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