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Medical Treatment of Moderately Severe and Vision-Threatening Graves’ Orbitopathy

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Graves' Disease

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Abstract

Immunosuppressive treatment is indicated for patients with active Graves’ orbitopathy (GO). Immunosuppressive treatment aims at deactivation of the disease process and allowing rehabilitative surgery, if still necessary, in an earlier stage. Till present, intravenously administered methylprednisolone has proved to be the most effective immunosuppressive treatment for patients with GO with few and minor complications as long as certain cumulative doses are administered. However, glucocorticosteroids are usually only the first step in arresting or reversing the manifestations of GO and at least 10–30 % of GO-patients do not respond to steroids at all. In particular, proptosis rarely responds. Orbital irradiation may be an alternative or adjuvant to glucocorticosteroids. Selenium has been effectively employed in patients with active and milder forms of GO. A number of other immunosuppressive agents have to be tested for their efficacy and safety for GO-patients.

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  1. Department of Ophthalmology, Academic Medical Center, University of Amsterdam, D2-431, Meibergdreef 9, 1105 AZ, Amsterdam, Noord-Holland, The Netherlands

    Maarten P. Mourits M.D., Ph.D.

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Correspondence to Maarten P. Mourits M.D., Ph.D. .

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  1. Mayo Clinic College of Medicine, Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, Minnesota, USA

    Rebecca S. Bahn

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Mourits, M.P. (2015). Medical Treatment of Moderately Severe and Vision-Threatening Graves’ Orbitopathy. In: Bahn, R. (eds) Graves' Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2534-6_19

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