Thyroid Eye Disease Service, Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Curr Opin Ophthalmol. 2019 Sep;30(5):401-406. doi: 10.1097/ICU.0000000000000596.
To offer an update on advances and controversies in the assessment, investigation and treatment of thyroid eye disease (TED), a disfiguring orbital autoimmune disease, which can manifest with diplopia and threaten not only sight - but also life.
Developments in biomarkers and imaging are helping to tailor the management of patients. Emerging therapies target different pathways in the disease and are informed by studies into TED pathogenesis: the last 2 years has, for example, seen the culmination of a two-decade long bench-to-bedside story in which an original focus on the IGF1 receptor has translated into an effective treatment for proptosis in thyroid eye disease. Whether this will result in a real-world reduction in TED-related morbidity will depend on access; commercial pricing decisions may preclude widespread adoption of novel therapies.
Thyroid eye disease research is enjoying a renaissance with advances in both monitoring and treatment coupled with a renewed emphasis on a holisitic approach, which includes aesthetic care for patients; this is perhaps the most exciting time to be part of the international thyroid eye disease community in decades - for physicians, surgeons and patients. The commercial window for break-through drugs are narrowing with an array of new therapeutic agents in the pipeline over the coming decade.
提供甲状腺眼病（TED）评估、研究和治疗方面的最新进展和争议，TED 是一种致残性眼眶自身免疫性疾病，可表现为复视，并不仅威胁视力，还威胁生命。
生物标志物和影像学的发展有助于针对患者进行管理。新兴疗法针对疾病的不同途径，并根据 TED 发病机制的研究：例如，过去 2 年见证了一项长达 20 年的从实验室到临床的研究的高潮，最初专注于 IGF1 受体已转化为甲状腺眼病突眼的有效治疗方法。这是否会导致 TED 相关发病率的实际降低将取决于能否获得治疗；商业定价决策可能会阻止新型疗法的广泛采用。
随着监测和治疗的进步，甲状腺眼病研究正在复兴，同时重新强调整体方法，包括为患者提供美容护理；这可能是几十年来参与国际甲状腺眼病社区的最令人兴奋的时刻——对于医生、外科医生和患者而言。突破性药物的商业窗口正在缩小，未来十年将有一系列新的治疗药物进入市场。
