Basic Principles of Treatment of Endocrine Ophthalmopathy. Literature review

Endocrine ophthalmopathy (EO) is one of the most common causes of exophthalmos in adults, as well as optic neuropathy resulting from orbital compartment syndrome. Complications such as persistent vision loss due to pathology of the anterior ocular surface and optic nerve involvement remain high. After compensation for the acute stage of the disease, cosmetic dissatisfaction becomes a primary concern due to significant changes in the periorbital tissues. Current diagnostics and the correct choice of treatment strategy based on the stage and activity of the pathological process are key factors in achieving a positive outcome, both in terms of clinical symptoms and aesthetic defects, particularly blepharochalasis and eyelid malposition. Various treatment methods exist, divided into medical and surgical. Each method has its own indications and contraindications, as well as side effects, which should be considered when choosing a strategy. The latter is especially important when selecting systemic drug therapy. In most cases, surgical treatment requires preliminary complete compensation of the thyroid gland’s hormonal and somatic status. Collaborative management with an endocrinologist is crucial. As noted above, the first step in treating EOP is drug therapy, which involves the use of glucocorticosteroidsin varying dosages, depending on the patient’s initial status and the endocrinologist’s recommendations. Further management is determined based on individual indications and includes various types of surgical treatment, among other options. A key aspect of the surgical approach is a properly developed step-by-step plan for the procedures. Each subsequent step should be a logical continuation of the previous stage of treatment.

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