Graves’ Ophthalmopathy

  • Lebriz Uslu Beşli


A 45-year-old female patient was diagnosed with Graves’ ophthalmopathy. She was euthyroid under methimazole treatment, and thyroid scan revealed bilateral diffuse hyperplasia of the thyroid gland. Orbital MRI revealed a symmetrical increase in the volume of all extraocular muscles as well as the expansion of retro-orbital fat tissue, which are in concordance with the presence of bilateral exophthalmos. TRAb level was moderately elevated, and CAS score was 1. The patient received 15 mCi (555 MBq) radioiodine with oral glucocorticoids, to avoid exacerbation of orbital inflammation. Hyperthyroidism resolved within 6 months without progression of the ophthalmopathy. Graves’ ophthalmopathy is an important clinical problem, as treatment of hyperfunctioning thyroid gland without triggering or exacerbating eye disease can be challenging. The presence and severity of orbital inflammation cannot be foreseen easily, and reversal of orbital damage cannot always be maintained. Several imaging modalities, biochemical parameters, and clinical assessment methods have been proposed to differentiate Graves’ patients with active orbital inflammation from the patients with the inactive stage of the disease. To date, orbital MRI, serum TRAB level assessment, and CAS score are the most common methods to assess ophthalmopathy activity.


Graves’ disease Exophthalmos Hyperthyroidism Graves’ ophthalmopathy Thyroid-associated ophthalmopathy Eye disease Goiter 


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© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Lebriz Uslu Beşli
    • 1
  1. 1.Department of Nuclear MedicineIstanbul University Cerrahpaşa Medical FacultyIstanbulTurkey

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