NTERIOR SEGMENT OCULAR SURFACE
The Battle of the Bulge
Pathogenesis & Treatments of Thyroid Eye Disease by Jillian Webster
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lthough the ultimate causes of thyroid eye disease (TED) are not completely understood, there are significant correlations between genetic, environmental, and nutritional factors, as well as the location of TSH receptors of IGF1 receptors. For example, Graves’ disease — an autoimmune disease that causes an overactive thyroid, as well as demographics, may be correlated to the development of TED. In the future, this condition will hopefully be treated prophylactically. This and other topics about thyroid eye disease were discussed by Dr. Sathyadeepak Ramesh from Wills Eye Hospital in Pennsylvania, USA, during a webinar organized by CyberSight in November last year.
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Understanding TED’s pathophysiology According to a study by Ardley et. al., heredity may be a gateway into early detection of TED. Dr. Ramesh highlighted that there is evidence of genetic heritability of one of the early signs of TED — lid retraction. In a Punnett square presented by Dr. Ramesh, he showed that there are correlative characteristics in genetics regarding the experience of TED, especially in females. As well as genetics, the patient’s environment can also contribute to the development of TED. Patients with
| Dec 2020/Jan 2021
Graves’ disease are at much greater risk of developing TED. Although the inheritability of Graves’ disease is still debated, the attributes shown in the study display some correlation. Diet and other lifestyle choices may also be correlated to the risk of developing TED. Tobacco smokers with Graves’ disease are at the highest risk of developing it, with the risk diminishing if the patient stops smoking. Those with the least risk are patients who have never smoked tobacco and maintain a healthy body. A well-balanced diet is also a way to prevent many diseases, including TED. Dr. Ramesh referenced studies that may suggest a correlation between the presence of selenium, vitamin D, and other micronutrients, and the reduction in TED-related inflammation. He recommended regular ingestion of a multivitamin combined with a complete diet for dietary prevention.
TED’s clinical and medicinal manifestations The understanding of TED begins on a
