Eckstein A, Dekowski D, Führer-Sakel D, Berchner-Pfannschmidt U, Esser J
Zentrum für Augenheilkunde, Abteilung für Erkrankungen des vorderen Augenabschnittes, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Deutschland.
Klinik für Endokrinologie und Stoffwechselerkrankungen, Universitätsklinikum Essen, Essen, Deutschland.
Ophthalmologe. 2016 Apr;113(4):349-64; quiz 465-6. doi: 10.1007/s00347-016-0239-3.
Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease and the full clinical picture can impair the quality of life of the patients considerably. Active inflammation can often be effectively treated by intravenous steroids/immunosuppression, however does not lead to full remission, since inflammation rather quickly results in irreversible fibrosis and increase of orbital fat. Very important is the control of risk factors (smoking cessation, good control of thyroid function, selenium supplementation) to prevent progression to severe stages. Treatment should rely on a thorough assessment of activity and severity of GO. Rehabilitative surgery (orbital decompression, squint surgery, eyelid surgery) is needed in many patients to restore function and appearance. Anti-thyroid-stimulating hormone (TSH) receptor antibodies do specifically occur in these patients and correlate to the course of thyroid and eye disease. The levels of these antibodies can be used for treatment decisions at certain time points of the disease.
格雷夫斯眼眶病（GO）是格雷夫斯病主要的甲状腺外表现，其完整的临床症状会严重损害患者的生活质量。活动性炎症通常可通过静脉注射类固醇/免疫抑制进行有效治疗，但不会完全缓解，因为炎症会很快导致不可逆的纤维化和眶脂肪增加。控制危险因素（戒烟、良好控制甲状腺功能、补充硒）以防止病情发展至严重阶段非常重要。治疗应基于对GO活动度和严重程度的全面评估。许多患者需要进行修复性手术（眼眶减压术、斜视手术、眼睑手术）以恢复功能和外观。抗促甲状腺激素（TSH）受体抗体在这些患者中确实会特异性出现，且与甲状腺和眼部疾病的病程相关。这些抗体的水平可用于疾病特定时间点的治疗决策。
