PubMed · 14901006
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M RICHARD. 1951-12-01. [Basedow's disease and hyperthyroidism].. https://pubmed.ncbi.nlm.nih.gov/14901006/
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Imaging of the extraocular muscles and orbital soft tissues in Graves' orbitopathy provides valuable information for both diagnosis and treatment decisions. However, assessment of the activity of the autoimmune process is often difficult. Currently available scoring systems for activity estimation are based merely on complaints and physical and ophthalmological examination. A reliable laboratory parameter correlating with disease activity is also missing. Sonography and magnetic resonance studies have pointed out, that thickening and/or edema of the extraocular muscles are often present before the onset of clinical symptoms and complaints. MRI and scintigraphy may provide important information upon the activity of the orbital process. Since the disease progrediates in the absence of therapy, it is essential to launch a properly timed immunosuppressive treatment in a selected group of patients. Based on their long-term experience in the Medical and Health Science Center of the University of Debrecen, Hungary, the authors review the currently available imaging methods in the diagnosis and follow up of endocrine orbitopathy, emphasizing their advantages and drawbacks.
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General health-related quality of life is markedly impaired in patients with Graves' ophthalmopathy (GO), and even worse than in patients with other chronic conditions like diabetes, emphysema or heart failure. A disease-specific quality-of-life questionnaire for GO has been developed, the so-called GO-QOL, consisting of two subscales: one for visual functioning (8 questions referring to limitations due to decreased visual acuity and/or diplopia) and one for appearance (8 questions referring to limitations in psychosocial functioning due to changes in appearance). The GO-QOL was found to be a valid and reliable instrument. A minimal clinically important difference (MCID) in the GO-QOL score was derived from data obtained before and after specific eye treatments. Based on the patient's opinions, changes of > or = 6 points (minor surgery) or > or = 10 points (surgical decompression, immunosuppression) are recommended as MCID. It is concluded that the GO-QOL is an useful instrument for measuring changes over time in visual functioning and appearance of GO patients. The GO-QOL is available in six languages, and can be used as a separate outcome measure in clinical studies.