COMMON COMPLICATIONS OF THYROID-ASSOCIATED OPHTHALMOPATHY (TAO) AND SURGICAL CORRECTION

Abstract

Thyroid-associated ophthalmopathy (OOT) is an autoimmune disease that affects the eyes, often associated with thyroid disorders. Characterized by inflammation and proliferation of orbital tissue, TAO can lead to a number of visual and aesthetic complications, significantly impacting patients' quality of life. Among the most common complications, proptosis (ocular protrusion), diplopia (double vision), ocular restriction, and orbital pain stand out. The severity of symptoms and disease progression vary widely among individuals, and treatment can be medical or surgical, depending on the severity of the condition and the response to drug therapy. Surgical correction is indicated in cases where clinical treatment is not effective or when there is a compromise significant visual development. Objective: The objective of this systematic review was to identify and analyze the available scientific evidence on the complications of OAT and the efficacy of surgical correction, in order to provide support for clinical practice and guide future research in the area. Methodology: The search was carried out in the PubMed, SciELO and Web of Science databases, using the following descriptors: "Graves' ophthalmopathy", "thyroid ophthalmopathy", "complications", "surgery" and "surgical correction". Original studies published in the last 10 years, in Portuguese and English, were included. The inclusion criteria were: studies that evaluated patients diagnosed with OOT, that described the complications of the disease and that evaluated the efficacy of surgery as a treatment. The exclusion criteria were: systematic reviews, meta-analyses, case studies, and studies that did not meet the requirements of thegave the inclusion criteria. Results: The literature review identified 12 studies that addressed the complications of OAT and surgical correction. The results showed that proptosis is the most frequent and impactful complication, which can lead to aesthetic deformities, diplopia and even visual loss. Orbital decompression surgery is the most commonly used procedure for the treatment of severe proptosis refractory to clinical treatment. The studies included in the review demonstrated that orbital decompression surgery is effective in reducing proptosis and improving visual function in many patients. However, surgery is also associated with complications such as bleeding, infection, and diplopia. Conclusion: OAT is a complex disease that can lead to significant visual and aesthetic complications. Orbital decompression surgery is a therapeutic option Effective for the treatment of severe proptosis refractory to medical treatment. However, the decision to indicate surgery must be individualized, taking into account the benefits and risks of each procedure. It is essential that the patient is adequately informed about the possible complications of the surgery and about the expectations of the result. Future studies are needed to evaluate the long-term efficacy of orbital decompression surgery and to identify new treatments for OOT.