Endocrinologic management of hyperthyroidism and the impact on thyroid eye disease

Thyroid eye disease (TED) is a complex inflammatory disease with a poorly understood etiopathogenesis. It is often, but not always, associated with Graves' disease and the endocrinologic manifestations of hyperthyroidism. Controversy exists regarding optimal treatment of hyperthyroidism especially with regard to the progression of orbitopathy. We review the literature examining the effectiveness of antithyroid drugs, radioactive iodine, and thyroidectomy for long-term endocrinologic management, and their effect on the progression of TED. In formulating an individualized treatment plan, considerations include rates of recurrent hyperthyroidism, treatment-associated complications, and effect on TED progression.