PDF(Pubmed)
Abstract：
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.
摘要：
甲状腺眼病（TED）是一种使人衰弱的自身免疫性疾病，通常与甲状腺功能障碍有关，导致显著的眼和眼眶发病率。这篇综述探讨了TED管理的最新进展，专注于医疗和外科创新。Teprotumumab的介绍，FDA批准的第一个专门用于TED的药物，标志着医学治疗的关键发展。Teprotumumab靶向胰岛素样生长因子-1受体（IGF-1R），有效减少炎症和组织重塑。临床试验证明其在减少眼球突出和改善生活质量方面的功效，使其成为治疗活跃的基石，中度至重度TED。对于患有慢性TED或对药物治疗无反应的患者，手术管理仍然至关重要。眼眶减压手术的进展，包括图像引导和微创技术，提供改善的结果和减少的并发症。眼睑和斜视手术的创新提高了功能和美容效果，进一步提高患者满意度。TED的管理需要涉及内分泌学家的多学科方法，眼科医生,眼整形外科医生,放射科医生,和其他专家。这种协作策略确保了全面的护理，解决TED的各个方面，从甲状腺功能障碍到眼部健康和心理健康。TED治疗的未来方向包括针对疾病病理生理学不同方面的新兴药物治疗和旨在提高精确度和安全性的先进外科技术。这篇评论强调了个性化的重要性，管理TED的多学科方法，强调当前的进步，并探索潜在的未来创新，以改善患者的预后和生活质量。
