Thyroid Eye Disease (TED) Samples
Fresh frozen biopsy tissue samples and matched bio-fluids are collected from unique patients diagnosed with thyroid eye disease (TED).
Thyroid Eye Disease (TED) Overview
Thyroid eye disease (TED), also known as Graves’ eye disease or Graves’ ophthalmopathy, is an inflammatory condition in patients with thyroid disease. Treatment may include medication, eye drops, and surgery.
Treatment focuses on managing thyroid disease and then treating the eye symptoms. In most cases, conservative treatment with lubricating eye drops helps with symptoms. However, some patients need corticosteroids or other medication. About 2 in 10 patients with thyroid eye disease will need surgery.
Causes of Thyroid Eye Disease (TED)
If you have an autoimmune disease like Graves’ disease, though, your immune system begins to fight against healthy tissues and cells in your body.
With Graves’ disease, instead of producing antibodies to target a specific invader, your immune system mistakenly produces thyroid-stimulating immunoglobulins. These antibodies then target your own healthy thyroid cells.
Scientists know that people can inherit the ability to make antibodies against their own healthy cells. But they have yet to find a clear cause of Graves’ disease or determine who will develop it.
Experts believe it’s possible that your genes and a virus or other external trigger both play a part in its development.
- Antibodies: Over time, a group of antibodies — anti-thyrotropin receptor antibodies, accumulate in the eye. Their presence causes pain and inflammation. The number of these antibodies correlates with the severity of TED symptoms.
- Hyperthyroidism: 9 in 10 people with TED have hyperthyroidism. 3 in 100 have Hashimoto’s disease, an autoimmune form of hypothyroidism.
- Immune cells: Researchers believe that the same immune cells that attack the thyroid to cause thyroid diseases, such as Graves’ disease, also attack body fat and other tissues around the eyes, especially a group of cells known as orbital fibroblasts.
- Smoking: Research shows that smoking is a significant risk factor for developing TED and for more severe cases of the condition.
Risk Factors of Thyroid Eye Disease (TED)
A few different factors may affect your chance of developing Graves’ disease:
- Age
- Genetics (family history of the condition)
- Stress
- Gender
Your risk also increases if you have another autoimmune disease. Examples include:
Diagnosis of Thyroid Eye Disease (TED)
In a person with new eye symptoms, a doctor may recommend bloodwork to test thyroid function. They will also ask about symptoms, examine the eyes, and ask about the history of symptoms.
Your doctor may request laboratory tests if they think you might have TED. If anyone in your family has had TED or Graves’ disease, your doctor may be able to narrow down the diagnosis based on your medical history and a physical examination.
They’ll still need to confirm the diagnosis through thyroid blood tests. A doctor who specializes in diseases related to hormones, known as an endocrinologist, may handle your tests and diagnosis.
Your doctor may also request some of the following tests:
- Thyroid-stimulating immunoglobulin testBlood test
- Thyroid ultrasound
- Radioactive iodine uptake test
- Thyroid-stimulating hormone test
The combined results of these may help your doctor learn if you have TED or another type of thyroid disorder.
Treatment of Thyroid Eye Disease (TED)
Medications
Steroids
In more severe cases that do not respond well to conservative treatment, a person may need to take a corticosteroid such as prednisone. These drugs weaken the immune reaction that in this case causes the body to attack the eyes and may reduce or even eliminate symptoms.
However, they also cause side effects and can weaken the immune system, so it is important for a person to try other treatments first.
Surgery
Orbital decompression removes a portion of the bone between the eye socket and sinuses, creating more space for the eye muscles, so they do not press on other structures. This may reduce bulging and pressure.
Psychological Support
It is also important to develop a plan to manage stress. This is because stress may make TED symptoms worse or reactivate TED when it is in remission.
Hyperthyroidism Treatment
- Radioactive iodine therapy
- Surgical removal of all or part of the thyroid, also known as a thyroidectomy
- Thionamide treatment
Outlook
While the outlook is good, TED can affect mental health and self-image, especially when it changes the appearance of the eyes and face. It may also cause ongoing painful flares. Social and psychological support are important.
When to Contact a Doctor
A person should contact a doctor for any vision problems or ongoing eye pain. People with a history of thyroid disease should see a doctor for dry eyes, eye pain, or vision changes, even if their thyroid disease is well-managed and in remission.
Treating TED may help prevent complications.
Summary
Thyroid eye disease can be very painful. It may make reading, looking at a computer, and other daily tasks unpleasant. It can also affect a person’s vision and, by extension, daily functions such as driving and hobbies.
TED responds well to treatment. Even when conservative treatment fails, several other treatments can reduce symptoms and prevent additional damage to the eye.
Types of Biospecimens
- Peripheral whole-blood
- Amniotic fluid
- Bronchoalveolar lavage fluid (BAL)
- Sputum
- Pleural effusion
- Cerebrospinal fluid (CSF)
- Serum (sera)
- Plasma
- Peripheral blood mononuclear cells (PBMC)
- Saliva
- Buffy coat
- Urine
- Stool samples
- Aqueous humor
- Vitreous humor
- Kidney stones (renal calculi)
- Other bodily fluids from most diseases including cancer.
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