Thyroid eye disease Flashcards
What percentage of patients with Graves’ disease are affected by thyroid eye disease?
Thyroid eye disease affects between 25-50% of patients with Graves’ disease.
What is the pathophysiology of thyroid eye disease?
It is thought to be caused by an autoimmune response against an autoantigen, possibly the TSH receptor, leading to retro-orbital inflammation and subsequent glycosaminoglycan and collagen deposition in the muscles.
What is the most important modifiable risk factor for thyroid eye disease?
Smoking is the most important modifiable risk factor for the development of thyroid eye disease.
What may increase inflammatory symptoms in thyroid eye disease?
Radioiodine treatment may increase the inflammatory symptoms seen in thyroid eye disease.
What are some features of thyroid eye disease?
Features include exophthalmos, conjunctival oedema, optic disc swelling, ophthalmoplegia, and inability to close the eyelids, which may lead to sore, dry eyes.
What are the management options for thyroid eye disease?
Management options include smoking cessation, topical lubricants, steroids, radiotherapy, and surgery.
What is the most common complication of thyroid eye disease?
Exposure keratopathy is the most common complication of thyroid eye disease.
What serious complication can occur due to thyroid eye disease?
Optic neuropathy is one of the most serious complications, occurring when enlarged extraocular muscles compress the optic nerve.
What symptoms indicate the need for urgent review by an ophthalmologist in established thyroid eye disease?
Symptoms include unexplained deterioration in vision, change in colour vision, globe subluxation, obvious corneal opacity, cornea visible when eyelids are closed, and disc swelling.
What are thyroid nodules?
Thyroid nodules may be noted by the patient, during a clinical examination or as a finding following imaging.
What is the primary aim of investigating thyroid nodules?
The primary aim is to exclude thyroid cancer, which accounts for around 5% of all nodules depending on the patient demographic.
What are some benign causes of thyroid nodules?
Benign causes include multinodular goitre, thyroid adenoma, Hashimoto’s thyroiditis, and cysts (colloid, simple, or hemorrhagic).
What are some malignant causes of thyroid nodules?
Malignant causes include papillary carcinoma (most common), follicular carcinoma, medullary carcinoma, anaplastic carcinoma, and lymphoma.
What should be checked in all patients with thyroid nodules?
Thyroid function should be checked in all patients.
What is the first-line imaging of choice for investigating thyroid nodules?
Ultrasonography is the first-line imaging of choice, which may help determine if the nodule has features suspicious of malignancy.
causes of thyroid nodules
