MODERN DIAGNOSTIC METHODS, EARLY DETECTION, AND MONITORING PROTOCOLS FOR OPHTHALMOPATHY IN WOMEN OF REPRODUCTIVE AGE

Abstract

Background: Thyroid eye disease (TED) is an autoimmune orbital disorder predominantly affecting women aged 18–45 years (Eckstein et al., 1997; Bartalena et al., 2016). Early detection and structured monitoring are critical to prevent vision loss and optimize outcomes. Objective: To review state-of-the-art diagnostic modalities, identify early clinical markers, and evaluate evidence-based monitoring protocols tailored for reproductive-aged women. Methods: We performed a narrative review of studies (2018–2025) in PubMed, Embase, and Web of Science using terms "thyroid eye disease," "diagnostics," "early signs," and "monitoring protocols." Eligible reports included adult women (18–45 years) and described clinical scoring, imaging, serology, or follow-up strategies (Population Medicine, 2023). Results: The Clinical Activity Score (CAS) remains the primary clinical tool (CAS ≥3 indicates active inflammation) (Eckstein et al., 1997). Advanced imaging (CT, MRI, ultrasound, OCT) enhances subclinical detection (Luccas et al., 2023; Waldstein, 2020). Serological markers—TSHR-Ab and emerging cytokine panels (IL-6, TNF-α)—correlate with activity (Bahn, 2016). Early signs include eyelid retraction, periorbital edema, and conjunctival injection (Verywell Health, 2021). Monitoring per EUGOGO/ATA guidelines calls for monthly CAS, imaging every 3–6 months in active disease, and biannual serology. Conclusions: A multimodal approach—standardized clinical scoring, advanced imaging, and serological profiling—enables early TED detection in reproductive-aged women. Structured follow-up per international guidelines facilitates timely interventions and improved patient-reported outcomes.