Thyroid Eye Disease - Understanding the Disease and New Treatments

Explore the causes, effects, and latest treatments for Thyroid Eye Disease in this informative lecture by Dr. Andrea Lora Kossler, Assistant Professor of Ophthalmology at Stanford University School of Medicine. Learn about the distressing impact of this condition on patients' appearance and vision, and discover how newly developed treatments can potentially alter the disease's progression. Gain insights into the multidisciplinary approach to managing Thyroid Eye Disease, including medical therapies, orbital radiation, and surgical options. Examine real-world case studies that illustrate the challenges and treatment strategies for various severities of the disease. Understand the role of biologic therapy, particularly teprotumumab, in addressing this autoimmune condition. Delve into the complexities of Graves' Disease, the systemic components involved, and the key players in the disease's pathophysiology. This comprehensive presentation covers everything from mild cases to vision-threatening complications, providing valuable knowledge for healthcare professionals and patients alike.

Intro
Thyroid Eye Disease: Understanding the Disease & New Treatments Andrea Lora Kossler, MD, FACS
OUTLINE
GRAVES DISEASE THE SYSTEMIC COMPONENTS
THYROID EYE DISEASE (TED)
AUTOIMMUNE DISEASE
KEY PLAYER TED: THE ORBITAL FIBROBLAST
TED PATHOPHYSIOLOGY
TED IS ASSOCIATED WITH SIGNIFICANT VISION-THREATENING IMPAIRMENTS
EYELID RETRACTION 911
DIPLOPIA (DOUBLE VISION) 43-51%
TED HAS BROAD IMPLICATIONS FOR PATIENTS' LIVES
MILD TED
LIMITED WINDOW FOR TREATMENT1-3
TREATMENT: MULTIDISCIPLINARY APPROACH
CASE 1: 67 YEAR OLD FEMALE WITH EYE REDNESS, SWELLING, & PAIN X 2 MONTHS
CURRENT MANAGEMENT OPTIONS FOR TED
STEROIDS WERE THE PREVIOUS GOLD STANDARD TREATMENT
MEDICAL THERAPY: ORBITAL RADIATION
VISION THREATENING TED
TREATMENT-COMPRESSIVE OPTIC NEUROPATHY
CASE 2: 45 YO MALE TED, PROPTOSIS OU, DOUBLE VISION, PAIN, SWELLING AND LOSS OF VISION
BIOLOGIC THERAPY
TEPROTUMUMAB RESPONSE
OPTIC (PHASE 3) PROSPECTIVE RANDOMIZED TRIAL
SURGERY IS CURRENTLY THE MAIN OPTION FOR FIBROTIC TED
27 FEMALE PROPTOSIS AND LAGOPHTHALMOS
EYELID CREASE INCISION
POST OP WEEK 3 SP LATERAL WALL DECOMPRESSION
CONCLUSION- THYROID EYE DISEASE