Thyroid eye disease requires personalized treatment approaches

October 12, 2022

1 minute read



Wester S. Go up an octave! Improving your treatment for thyroid eye disease. Presented at the meeting of the American Academy of Ophthalmology; Sept. 30-Oct. 3, 2022; Chicago.

Wester reports advising/consulting for Horizon Therapeutics, Immunovant and Sling.

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CHICAGO – New targeted therapies and improvements in surgical techniques are driving a change in expectations and outcomes for patients with thyroid eye disease.

“However, the more we learn about this disease, the more we understand that every patient is different and that no treatment, medical or surgical, works for everyone,” Sara Wester, MDFACS, said at the meeting of the American Academy of Ophthalmology.


Treatment strategies are based on two key aspects of the disease: activity and severity. Early treatment of disease is important because the final stage of stable, inactive disease is usually associated with permanent abnormalities in function and appearance.

“In many patients, medical treatment works well, but we still don’t know why drugs work well in some people and not in others. Or why specific drugs, including biologics, are effective in some patients and not others,” Wester said.

It is important to discuss with patients the advantages and disadvantages of the different options. In one of his patients, a musician concerned about audiology issues, the best choice was tocilizumab over newer biologics that might have better efficacy but carry the risk of hearing loss as a potential side effect.

The indications for surgery have also changed. Orbital decompression is still the gold standard, but the latest survey from the American Society of Ophthalmic Plastic and Reconstructive Surgery has shown that specialists have turned to more lateral wall decompression, and technical advances provide a flat -shape for personalized surgical approaches.

“Although we have great drugs, surgery still plays an important role,” Wester said.

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