Orphanet J Rare Dis (2017) 12:72. doi: 10.1186/s13023-017-0625-1, 3. Perros P, Zarkovic MP, Panagiotou GC, Azzolini C, Ayvaz G, Baldeschi L, et al. doi: 10.1136/bjo.2007.137265, 35. Demographic and clinical profile of 1000 patients with thyroid eye disease presenting to a Tertiary Eye Care Institute in India. Arch Ophthalmol (1993) 111:197–201. Psychosocial morbidity of Graves’ orbitopathy. Journals range from life sciences and health to engineering, robotics and humanities. doi: 10.1371/journal.pone.0119589, 19. doi: 10.1043/0003-3219(1978)048<0141:AAOAIT>2.0.CO;2, 16. Loop is the open research network that increases the discoverability and impact of researchers and their work. However, there are no prospective data evaluating whether early selenium supplementation in asymmetric GO cases may halt progression to bilateral symptoms. Your IP: 22.214.171.124 doi: 10.1043/0003-3219(1981)051<0214:IOCA>2.0.CO;2, 15. doi: 10.1016/j.bjps.2006.07.001, 20. Endocrinol., 17 December 2020 With an Impact Factor of 3.519 Frontiers in Endocrinology is the 4th most-cited open-access Endocrinology & Metabolism journal and ranks in top impact metrics FRONTIERS HOME ABOUT Soroudi AE, Goldberg RA, McCann JD. *Correspondence: Grigorios Panagiotou, email@example.com, Front. Chin YH, Ng CH, Lee MH, Koh JWH, Kiew J, Yang SP, et al. Ophthalmic Plast Reconstr Surg (2006) 22:319–24. Diagnosing unilateral or asymmetric GO without any other signs of GO and especially in the absence of hyperthyroidism or high TRAb titer suggestive of Graves’ disease can be challenging (41) and requires increased clinical awareness and usually imaging of the orbits. The mechanisms leading to asymmetric disease discussed are speculative. BioMed Res Int (2018) 2018:4845894. doi: 10.1155/2018/4845894, 45. doi: 10.1111/j.1365-2265.1993.tb00516.x, 39. 11:611845. doi: 10.3389/fendo.2020.611845. Only Open Access Journals Only SciELO Journals Only WoS Journals 2010-2020: Scope: Frontiers in Endocrinology publishes rigorously peer-reviewed research from basic molecular and cellular communication to clinical care, advancing our understanding of the endocrine system, and leading to novel therapies for some of the most prevalent health issues such as obesity, diabetes, reproduction and aging. Performance & security by Cloudflare, Please complete the security check to access. doi: 10.1097/OPX.0b013e3181890dc7, 22. Loop is the open research network that increases the discoverability and impact of researchers and their work. and diplopia (3) being the most common features. GO is closely associated with thyroid autoimmunity, and although it is classically linked with hyperthyroidism, GO features have been described in hypothyroid or euthyroid individuals (4). Am J Med Sci (2012) 344:418–21. Facial asymmetry as an indicator of psychological, emotional, and physiological distress. It is important to note that published studies have used different definitions of asymmetry and/or unilateral GO and this might explain the big variation in reported epidemiology among published data. Thyroid (2015) 25:942–8. However, despite previous postulations the exact mechanisms remain elusive. Loop is the open research network that increases the discoverability and impact of researchers and their work. Verma SK, Jain N, Saraf S, Singh SK. doi: 10.1016/j.ejim.2008.01.013, 26. In the same study asymmetry was more prevalent in females and measurements from the right orbit were greater than the left (16). doi: 10.1007/s10792-020-01571-6, 34. Other differentials affecting the orbit including other orbital tumors or pseudotumors, carotid cavernous fistulae, and dermoid and/or epidermoid cysts need to be excluded, too. Tsai CC, Kau HC, Kao SC, Hsu WM. Furthermore, less is known in regards to the epidemiology of unilateral or asymmetric GO in children. Shah SM, Joshi MR. An assessment of asymmetry in the normal craniofacial complex. Frontiers in Endocrinology publishes rigorously peer-reviewed research from basic molecular and cellular communication to clinical care, advancing our understanding of the endocrine system, and leading to novel therapies for some of the most prevalent health issues such as obesity, diabetes, reproduction and aging.. Research network for academics to stay up-to-date with the latest scientific publications, events, jobs, video lectures, blogs and news. 10 doi: 10.4158/EP.7.2.110, 41. Bahn RS. Long-term multidisciplinary follow-up of unilateral thyroid-associated orbitopathy. Targeted therapies such as teprotumumab, an anti-Insulin Growth Factor 1 (IGF-1) receptor monoclonal antibody, were shown to be effective in patients with active GO (47), but its role in asymmetric or unilateral GO is unexplored. doi: 10.1111/j.1365-2265.2005.02352.x, 9. doi: 10.1530/EJE-07-0450, 43. • View all However, some patients might exhibit asymmetric or unilateral symptoms, for yet unknown reasons. If you are on a personal connection, like at home, you can run an anti-virus scan on your device to make sure it is not infected with malware. BMC Ophthalmol (2013) 13:21. doi: 10.1186/1471-2415-13-21, 12. doi: 10.1016/j.ajo.2011.02.018, 11. doi: 10.1056/NEJMoa1910434, Keywords: asymmetry, Graves’ disease, exophthalmos, unilateral, hyperthyroidism, Citation: Panagiotou G and Perros P (2020) Asymmetric Graves’ Orbitopathy. Douglas RS, Kahaly GJ, Patel A, Sile S, Thompson EHZ, Perdok R, et al. In our recently published study, asymmetry was defined as bilateral disease with one or more of the following features: difference between the two eyes in exophthalmos by ≥2 mm; difference in palpebral aperture by ≥2 mm; difference in eyelid swelling by ≥1 grades; difference in eyelid erythema by ≥1 grades; difference in conjunctival redness by ≥1 grades; presence of dysthyroid optic neuropathy in one eye only. Fox TJ, Anastasopoulou C. Graves Orbitopathy. Li Q, Ye H, Ding Y, Chen G, Liu Z, Xu J, et al. Elasticity of orbital septae or other local factors, associated with unilateral triggers such as infections or difference in potential for adipogenesis have also been suggested (12). Am J Ophthalmol (2011) 152:483–490 e1. Buescu A, Teixeira P, Coelho S, Donangelo I, Vaisman M. Orbital lymphoma misdiagnosed as Graves’ ophthalmopathy. Clin Endocrinol (2020). Kashkouli MB, Kaghazkanani R, Heidari I, Ketabi N, Jam S, Azarnia S, et al. Moreover, disease severity is assessed similarly to bilateral disease, using clinically evaluated standardized tools, such as CAS (27) and Vision, Inflammation, Strabismus, Appearance (VISA) (28). Indices of craniofacial asymmetry. Orbital lymphoma mimicking ophthalmopathy in a patient with Graves’. However, the exact mechanisms causing asymmetry remain elusive. Prummel MF, Bakker A, Wiersinga WM, Baldeschi L, Mourits MP, Kendall-Taylor P, et al. doi: 10.1111/j.1440-1673.2007.01721.x, 25. Impact Factor 3.644 ... Diabetes is a specialty section of Frontiers in Endocrinology and Frontiers in Public Health. Normal values of hertel exophthalmometry in children, teenagers, and adults from Tehran, Iran. Articles, Dipartimento di Endocrinologia, Fondazione IRCCS Ospedale Ca 'Granda Maggiore Policlinico, Italy. ... 2020. doi: 10.3109/01676830903162841, 17. ISSN: 0013-7227. Background and Aims: The synthetic atypical cannabinoid Abn-CBD, a cannabidiol (CBD) derivative, has been recently shown to modulate the immune system in different organs, but its impact in obesity-related meta-inflammation remains unstudied. Taylor PN, Zhang L, Lee RWJ, Muller I, Ezra DG, Dayan CM, et al. Asymmetric and unilateral GO are recognized features of GO with variable prevalence among different studies; however, they do not seem to represent a distinct variant of classical GO, rather than the extreme of the spectrum, and thus focused studies are scarce. New insights into the pathogenesis and nonsurgical management of Graves orbitopathy. showed that a seven-fold higher risk for unilateral GO in hypothyroid or euthyroid subjects, compared with hyperthyroid GO (26). 7. Copyright © 2020 Panagiotou and Perros. Eur J Endocrinol (2003) 148:491–5. Therefore, more studies are needed to study asymmetric GO and shed light on the mechanisms leading to asymmetry. Clin Endocrinol (2017) 86:247–55. Mourits MP, Prummel MF, Wiersinga WM, Koornneef L. Clinical activity score as a guide in the management of patients with Graves’ ophthalmopathy. Front. For more severe cases, methylprednisolone infusion (44) and/or administration of immune-modifying therapies, such as rituximab (45) and/or mycophenolate mofetil (46) may need to be considered. In specific, small studies have suggested that euthyroid and primarily hypothyroid patients develop more asymmetrical GO (34, 35), which tends to present more mildly. Br J Ophthalmol (2009) 93:1052–6. doi: 10.1038/s41574-019-0305-4, 6. Older age, male sex, active and severe disease correlate with asymmetric disease. However, since asymmetric disease may progress to bilateral GO thereby increasing patients’ anxiety and deteriorating their mental health status and quality of life as alluded to above, it is important that patients are managed promptly. Journal Impact 2018 di Frontiers in Endocrinology è 3.630 (Ultimi dati nel 2019). 1. Unilateral proptosis in thyroid eye disease with subsequent contralateral involvement: retrospective follow-up study. In the future, mechanistic studies are needed to explore the underlying pathological processes in asymmetric/unilateral GO. The presence of GO is associated with increased psychological burden and, in severe cases may cause blindness. Endocrinol. 11:589994. doi: 10.3389/fendo.2020.589994. Bilateral versus unilateral thyroid eye disease. Ophthalmic plastic and reconstructive surgery. Wiersinga WM, Bleumink M, Saeed P, Baldeschi L, Prummel MF. Endocrinol. Indian J Ophthalmol (2011) 59:363–6. Loop enables you to stay up-to-date with the latest discoveries and news, connect with researchers and form new collaborations. Thyroid (2017) 27:1475–80. Shorter duration of symptoms (29) and thyroid status might be associated with asymmetry. J Pers Soc Psychol (1997) 72:456–66. Given that the pathophysiological mechanisms causing unilateral or asymmetric GO appear to be similar to the well-described bilateral GO, treatment of asymmetric GO is generally the same with bilateral disease and is usually dependent on disease severity. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). BMJ Case Rep (2013) 2013:bcr2012007485. Shyu VB, Hsu CE, Chen CH, Chen CT. 3D-assisted quantitative assessment of orbital volume using an open-source software platform in a Taiwanese population. Prevalence of thyroid eye disease in Graves’ disease: A meta-analysis and systematic review. doi: 10.1530/EJE-18-0039. Received: 29 September 2020; Accepted: 16 November 2020;Published: 17 December 2020. Such studies may provide further answers in regards to GO development and management. Kendler DL, Lippa J, Rootman J. On the other hand, orbital volume calculation using CT scanning has shown no differences between orbits or gender in a Taiwanese normal population (18). Kahaly GJ, Petrak F, Hardt J, Pitz S, Egle UT. In another study, male subjects exhibited asymmetric disease (proptosis and overall asymmetry) three-fold more frequently compared with women, while women with hyperthyroidism demonstrated more symmetry compared with euthyroid and hypothyroid individuals of either sexes (23). Endocr Pract (2001) 7:110–2. Loop enables you to stay up-to-date with the latest discoveries and news, connect with researchers and form new collaborations. Journals. Oherle K, Acker E, Bonfield M, Wang T, Gray J, Lang I, et al. Many risks factors have been associated with asymmetry. Australas Radiol (2007) 51:253–6. Teprotumumab for the Treatment of Active Thyroid Eye Disease. Eckstein AK, Losch C, Glowacka D, Schott M, Mann K, Esser J, et al. 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