Uddin Jimmy M, Rubinstein Tal, Hamed-Azzam Shirin
Moorfields Eye Hospital, Adnexal Service, London, United Kingdom.
Ophthalmic Plast Reconstr Surg. 2018 Jul/Aug;34(4S Suppl 1):S28-S33. doi: 10.1097/IOP.0000000000001147.
To describe a new classification system of thyroid eye disease (TED) based on the phenotypic features (clinical and radiologic) of the disease.
Clinical features, photographic, and orbital imaging of TED patients were considered in relation to their natural history and treatment response in the experience of the author. Phenotypically distinct categories of patients were identified and described.
Six phenotypes of TED are observed: 1) congestive (active inflammatory), 2) "white eye" expansion, 3) "hydraulic" apex, 4) "white eye" apex, 5) cicatricial active, and 6) cicatricial passive.
The observable characteristics of TED are determined by the underlying pathophysiology of the disease. TED is heterogeneous in its underlying pathogenesis, clinical manifestations, and response to medical and surgical treatment modalities. Several previous categorizations of the clinical appearance of TED exist, but they are dichotomous and underrepresent the heterogeneity of the disease. The authors present clinical and radiologic features of 6 different classes or phenotypes of TED and their response to different treatments.
基于甲状腺眼病（TED）的表型特征（临床和放射学）描述一种新的分类系统。
结合作者经验，考虑TED患者的临床特征、照片及眼眶成像与疾病自然史和治疗反应的关系。识别并描述表型不同的患者类别。
观察到TED的六种表型：1）充血性（活动性炎症），2）“白眼”扩张，3）“液压性”眶尖，4）“白眼”眶尖，5）瘢痕性活动性，6）瘢痕性静止性。
TED的可观察特征由疾病的潜在病理生理学决定。TED在其潜在发病机制、临床表现以及对药物和手术治疗方式的反应方面具有异质性。之前存在几种TED临床表现的分类，但都是二分法，未能充分体现该疾病的异质性。作者介绍了TED的6种不同类别或表型的临床和放射学特征及其对不同治疗的反应。
