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.
Keywords
Graves’ orbitopathy; thyroid eye disease; diagnostics; monitoring protocols; reproductive ageHow to Cite
References
1.International Committee of Medical Journal Editors. (2004). Uniform requirements for manuscripts submitted to biomedical journals. ICMJE.
2.International Committee of Medical Journal Editors. (2018). Manuscript preparation and submission. ICMJE.
3.Population Medicine. (2023). Manuscript types and formatting. Population Medicine.
4.Bartalena, L., Baldeschi, L., Dickinson, A. J., Eckstein, A., Kendall-Taylor, P., Marcocci, C., Mourits, M. P., Neumann, S., Oeverhaus, M., Perros, P., & Wiersinga, W. M. (2016). The 2016 EUGOGO guidelines for management of Graves’ orbitopathy. European Thyroid Journal, 5(1), 9–26.
5.Bahn, R. S. (2016). Hyperthyroidism and other causes of thyrotoxicosis: ATA/AACE guidelines. Thyroid, 26(10), 1343–1421.
6.Eckstein, A., Mourits, M. P., & Koornneef, L. (1997). Clinical Activity Score in Graves’ orbitopathy. Thyroid, 7(1), 1–6.
7.Luccas, F., Salvi, M., Pérez-Mato, M., & Thyroid Eye Disease Imaging Group. (2023). Imaging approaches to thyroid eye disease. Frontiers in Endocrinology, 14, Article 115.
8.Endocrine Practice. (2020). Risk factors of thyroid eye disease. Endocrine Practice, 26(5), 522–530.
9.Verywell Health. (2021). Early symptoms of thyroid eye disease.
10.Smith, T. J. (2021). Comment on the 2021 EUGOGO clinical practice guidelines. European Journal of Endocrinology, 185(6), L13–L14.
11.Endocrine Practice. (2024). Novel measures of quality of life for thyroid eye disease. Endocrine Practice, 30(2), 200–209.
12.American Thyroid Association & American Association of Clinical Endocrinologists. (2016). Guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid.
13.European Group on Graves’ Orbitopathy (EUGOGO). (2021). Clinical practice guidelines for Graves’ orbitopathy. EUGOGO.
14.ScienceDirect. (1994). Diagnostic criteria for Graves’ ophthalmopathy.
15.Acta Medica Indonesiana. (2019). Practical guidelines for Graves’ ophthalmopathy. Acta Medica Indonesiana.
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