Scarabosio Anna, Surico Pier Luigi, Singh Rohan Bir, Tereshenko Vlad, Musa Mutali, D'Esposito Fabiana, Russo Andrea, Longo Antonio, Gagliano Caterina, Agosti Edoardo, Jhanji Etash, Zeppieri Marco
Clinic of Plastic and Reconstructive Surgery, Ospedale Santa Maria della Misericordia, 33100 Udine, Italy.
Department of Plastic and Reconstructive Surgery, Mass General Hospital, Harvard Medical School, Boston, MA 02114, USA.
J Pers Med. 2024 Jul 22;14(7):776. doi: 10.3390/jpm14070776.
Thyroid Eye Disease (TED) is a debilitating autoimmune condition often associated with thyroid dysfunction, leading to significant ocular and orbital morbidity. This review explores recent advancements in the management of TED, focusing on both medical and surgical innovations. The introduction of Teprotumumab, the first FDA-approved drug specifically for TED, marks a pivotal development in medical therapy. Teprotumumab targets the insulin-like growth factor-1 receptor (IGF-1R), effectively reducing inflammation and tissue remodeling. Clinical trials demonstrate its efficacy in reducing proptosis and improving quality of life, making it a cornerstone in the treatment of active, moderate-to-severe TED. Surgical management remains critical for patients with chronic TED or those unresponsive to medical therapy. Advancements in orbital decompression surgery, including image-guided and minimally invasive techniques, offer improved outcomes and reduced complications. Innovations in eyelid and strabismus surgery enhance functional and cosmetic results, further improving patient satisfaction. The management of TED necessitates a multidisciplinary approach involving endocrinologists, ophthalmologists, oculoplastic surgeons, radiologists, and other specialists. This collaborative strategy ensures comprehensive care, addressing the diverse aspects of TED from thyroid dysfunction to ocular health and psychological well-being. Future directions in TED treatment include emerging pharmacological therapies targeting different aspects of the disease's pathophysiology and advanced surgical techniques aimed at enhancing precision and safety. This review underscores the importance of a personalized, multidisciplinary approach in managing TED, highlighting current advancements, and exploring potential future innovations to improve patient outcomes and quality of life.
甲状腺眼病（TED）是一种使人衰弱的自身免疫性疾病，常与甲状腺功能障碍相关，会导致严重的眼部和眼眶病变。本综述探讨了TED治疗的最新进展，重点关注医学和外科创新。首个获得美国食品药品监督管理局（FDA）批准专门用于治疗TED的药物替普罗单抗的推出，标志着医学治疗领域的一个关键进展。替普罗单抗靶向胰岛素样生长因子-1受体（IGF-1R），有效减轻炎症和组织重塑。临床试验证明其在减轻眼球突出和改善生活质量方面的疗效，使其成为治疗活动性、中重度TED的基石。对于慢性TED患者或对药物治疗无反应的患者，手术治疗仍然至关重要。眼眶减压手术的进展，包括图像引导和微创技术，可提供更好的治疗效果并减少并发症。眼睑和斜视手术的创新提高了功能和美容效果，进一步提高了患者满意度。TED的治疗需要内分泌科医生、眼科医生、眼整形外科医生、放射科医生和其他专家的多学科方法。这种协作策略可确保全面护理，解决从甲状腺功能障碍到眼部健康和心理健康等TED的各个方面问题。TED治疗的未来方向包括针对该疾病病理生理学不同方面的新兴药物疗法以及旨在提高精准度和安全性的先进手术技术。本综述强调了个性化、多学科方法在管理TED中的重要性，突出了当前的进展，并探索了潜在的未来创新，以改善患者的治疗效果和生活质量。
