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Thyroid Eye Disease

Thyroid eye disease (TED), also known as thyroid-associated ophthalmopathy, Graves’ ophthalmopathy, or Graves’ orbitopathy, is a debilitating and painful autoimmune disease that causes eye bulging and vision change. In serious cases, TED can lead to loss of vision and blindness. The primary pathophysiology of TED is thought to occur via activating autoantibodies to thyrotropin receptors (TSHRs) on orbital fibroblasts.

Stimulation of these receptors leads to downstream IGF-1R-mediated inflammatory processes that cause expanded orbital tissue. This manifests clinically as eye redness, diplopia, and proptosis that can require surgical intervention to prevent or mitigate vision loss. Current treatment options include corticosteroids and the anti-IGF-1R mAb teprotumumab (TEPEZZA^®).