Abstract SE1-1
GRAVES’ OPHTHALMOPATHY-CLINICAL EXPERIENCES IN KOREA JEE HEE YOON Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
Graves’ disease is the most common cause of thyrotoxicosis in Korea (82.7%) and up to 50% of patients with Graves’ disease develop Graves’s ophthalmopathy (GO). GO is related to the loss of immune tolerance to the thyrotropic receptor (TSHR) andorbital fibroblasts, the target cell of GO, increase connective tissue edema in the bony orbits by secreting pro-inflammatory cytokines andhydrophilic hyaluronanin early phase and lead to orbital adipose tissue expansion by differentiating to mature adipocyte in late phase. The pathogenesis of GO is becoming more clear, but some part of that is still understood incompletely. For the optimal management of GO, reducing risk factors and proper approach depending on clinical activity of GO (active inflammatory phase and chronic static phase) are necessary. The cessation of smoking and sustenance of a euthyroid state is helpful for the decreasing risk factors. For reducing inflammation in patients with active GO, systemic steroid only or with radiotherapy generally, but clinical outcome is sometimes insufficient. Other approaches for targeting immune mechanism of active GO were studied and good result of teprotumumab targeting for insulin-like growth factor-I (IGF-I) is reported recently. Surgery is indicated for emergent optic compression and management of chronic phase. In this session, I hope to share our cases of GO and clinical data in Korea.
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