Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Neuro-Ophthalmology Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Ophthalmol. 2018 Nov;29(6):528-534. doi: 10.1097/ICU.0000000000000529.
The pathophysiology of thyroid eye disease (TED) is still not fully understood. However, recently described risk factors and molecular findings have brought new insights into the mechanisms of TED and could lead to the emerging use of more targeted therapies. This article aims to review the clinical findings of TED, and the most recent advances in our understanding of the risk factors and therapeutic options for TED.
Smoking has been recently shown to have an impact on specific gene expression involved in several disease-related pathways, which seems to be reversible with smoking cessation. This finding further emphasizes the importance of smoking cessation in the prevention and treatment of TED. Selenium deficiency and high-serum cholesterol have been described to be potential independent risk factors for TED and their management could decrease the incidence and severity of TED. In terms of therapeutic options, immunomodulatory medications have shown some promising results for disease control in TED over the past years, but further randomized prospective studies with larger sample sizes are still needed to prove their efficacy. A new technique of P brachytherapy was shown to have quick therapeutic effects on TED without significant side effects and could be a promising therapy for selected cases of TED.
TED is one of the most common autoimmune inflammatory disorders of the orbit. Although its pathophysiology remains unclear, newly described genetic findings and risk factors could help in explaining its occurrence and guide future therapies. Immunosuppressant medications are increasingly used in the management of TED, but further studies are needed to confirm their effectiveness.
甲状腺眼病（TED）的发病机制仍不完全清楚。然而，最近描述的风险因素和分子发现为 TED 的发病机制提供了新的见解，并可能导致更有针对性的治疗方法的出现。本文旨在综述 TED 的临床发现，以及我们对 TED 的风险因素和治疗选择的最新认识。
吸烟最近被证明对涉及几种疾病相关途径的特定基因表达有影响，而这种影响似乎可以通过戒烟来逆转。这一发现进一步强调了戒烟在预防和治疗 TED 中的重要性。硒缺乏和高血清胆固醇被描述为 TED 的潜在独立危险因素，其管理可以降低 TED 的发生率和严重程度。在治疗选择方面，免疫调节药物在过去几年中对 TED 的疾病控制显示出一些有希望的结果，但仍需要更大样本量的随机前瞻性研究来证明其疗效。P 近距离放射疗法的新技术被证明对 TED 具有快速的治疗效果，且没有明显的副作用，可能是 TED 某些病例的一种有前途的治疗方法。
TED 是眼眶最常见的自身免疫性炎症性疾病之一。尽管其发病机制仍不清楚，但新描述的遗传发现和风险因素有助于解释其发生，并指导未来的治疗。免疫抑制剂药物越来越多地用于 TED 的治疗，但仍需要进一步的研究来证实其有效性。
