Advances in the Management of Thyroid Eye Disease
As the pathogenesis of TED is better characterized, the need for a patient centered, multidisciplinary approach has become more obvious. Careful and coordinated consideration of individual patient needs requires input from various specialists throughout the disease process, with the endocrinologist and ophthalmologist being the primary providers. TED patients require careful endocrine monitoring to maintain euthyroidism and often require definitive treatment of their underlying thyroid condition by means of radioactive iodine therapy or thyroidectomy. Furthermore, the use of immunosuppressive therapies or biological agents may require the expertise of a rheumatologist. Smoking cessation is also important, as smoking has been shown to increase both the incidence and severity of TED. Patients must be given all the necessary resources and counseling to achieve smoking cessation as quickly as possible.
Several academic centers throughout the country have established multidisciplinary thyroid eye disease teams to facilitate communication and share in treatment decisions on an individual patient level. The goal is to provide all the necessary subspecialty care at a single institution, in a coordinated manner, and to create a multidisciplinary forum to optimize patient-centered care delivery (Fig. 2). These centers also seek to raise awareness in the community, thus helping to diagnose and treat patients in a more efficient manner.
(Enlarge Image)
Figure 2.
A, Old Referral Paradigm: patients were referred from service to service with little communication between physicians. B, Thyroid Eye Disease Center Paradigm: patient-centered approach with simultaneous, coordinated care from various specialties.
Multidisciplinary Approach
As the pathogenesis of TED is better characterized, the need for a patient centered, multidisciplinary approach has become more obvious. Careful and coordinated consideration of individual patient needs requires input from various specialists throughout the disease process, with the endocrinologist and ophthalmologist being the primary providers. TED patients require careful endocrine monitoring to maintain euthyroidism and often require definitive treatment of their underlying thyroid condition by means of radioactive iodine therapy or thyroidectomy. Furthermore, the use of immunosuppressive therapies or biological agents may require the expertise of a rheumatologist. Smoking cessation is also important, as smoking has been shown to increase both the incidence and severity of TED. Patients must be given all the necessary resources and counseling to achieve smoking cessation as quickly as possible.
Several academic centers throughout the country have established multidisciplinary thyroid eye disease teams to facilitate communication and share in treatment decisions on an individual patient level. The goal is to provide all the necessary subspecialty care at a single institution, in a coordinated manner, and to create a multidisciplinary forum to optimize patient-centered care delivery (Fig. 2). These centers also seek to raise awareness in the community, thus helping to diagnose and treat patients in a more efficient manner.
(Enlarge Image)
Figure 2.
A, Old Referral Paradigm: patients were referred from service to service with little communication between physicians. B, Thyroid Eye Disease Center Paradigm: patient-centered approach with simultaneous, coordinated care from various specialties.
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