GRAVES' DISEASE: ENDOCRINOLOGICAL EVALUATION AND OPHTHALMOLOGICAL MANIFESTATIONS

Abstract

Graves' disease is an autoimmune disease that affects the thyroid gland, leading to excessive production of thyroid hormones (hyperthyroidism). This condition can cause several clinical manifestations, the most common being Graves' ophthalmopathy, characterized by an increase in the volume of muscles and fat in the ocular orbit, resulting in proptosis (bulging eyes), edema and eyelid hyperemia, restriction of ocular motility, changes vision and, in severe cases, optic neuropathy and blindness. Objective: to evaluate the scientific literature on Graves' disease, with an emphasis on endocrinological evaluation and ophthalmological manifestations. Methodology: A search was carried out in the PubMed, Scielo and Web of Science databases, using the following descriptors: “Graves disease”, “thyroid eye disease”, “orbitopathy”, “endocrinology”, “ophthalmology”. Articles published in the last 10 years (2013-2023), in Portuguese or English, that addressed epidemiological, pathophysiological, diagnostic or therapeutic aspects of Graves' disease and Graves' ophthalmopathy were included. Articles that were not related to the proposed topic, that were duplicates, that had low methodological quality or that were not available in full were excluded. The selection of articles was made following the PRISMA checklist. Results: 17 articles were selected to compose this review. The main topics covered were: the epidemiology of Graves' disease and Graves' ophthalmopathy; the immunological mechanisms involved in the pathogenesis of the disease; risk factors and prognostic factors for the development and progression of ophthalmopathy; clinical and complementary diagnostic methods; the therapeutic options available for controlling hyperthyroidism and managing ophthalmopathy; the complications and clinical outcomes of the disease. Conclusion: Graves' disease is a complex autoimmune disease that affects the thyroid gland and other organs, especially the eyes. Graves' ophthalmopathy is a frequent and potentially serious manifestation of Graves' disease, which requires a multidisciplinary approach between endocrinologists and ophthalmologists. Early diagnosis and appropriate treatment are essential to prevent or minimize the visual and aesthetic sequelae of the disease.