Эндокринологам поручено взять на себя ведущую роль в ранней диагностике и лечении болезни Грейвса-офтальмопатия

Fact checked by Richard Smith Purpose-built for physicians Learn more September 08, 2026 4 min read Fact checked by Richard Smith Add topic to email alerts Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on. Added to email alerts You've successfully added to your alerts. You will receive an email when new content is published. Click Here to Manage Email Alerts You've successfully added to your alerts. You will receive an email when new content is published. Click Here to Manage Email Alerts We were unable to process your request. Please try again later. If you continue to have this issue please contact [email protected]. Key takeaways: The FDA approval of teprotumumab-trbw and veligrotug-vvze have expanded the options for treating thyroid eye disease. Endocrinologists can screen for and detect thyroid eye disease at an early stage. The availability of new treatments for thyroid eye disease provides endocrinologists an opportunity to take the lead in managing the disease, according to an article published in AACE Endocrinology and Diabetes. In decades past, thyroid eye disease was a challenging condition to treat due to the lack of therapy options outside of steroids, said Thanh D. Hoang, DO, MACP, FACE, professor of medicine at the Uniformed Services University of the Health Sciences. However, the FDA approval of teprotumumab-trbw (Tepezza, Amgen) in 2020 and veligrotug-vvze (Lumvoa, Viridian Therapeutics) in 2026 have changed the treatment landscape for healthcare professionals. With multiple therapies now available, Hoang said, endocrinologists now can identify thyroid eye disease and treat it early in the disease course. In a commentary article, Hoang discussed why endocrinologists should serve as the “clinical anchor” for thyroid eye disease care. “When I talk to a lot of endocrinologists working in different facilities, people think thyroid eye disease is an eye condition you just refer to the eye doctor and that’s it,” Hoang told Healio. “I wanted to write this commentary so we can better educate the endocrinologists so that we can take charge and improve patient care for thyroid eye disease.” Healio spoke with Hoang about why endocrinologists should take the lead on thyroid eye disease management, the various steps of screening for the disease and how education about the condition can be improved in the endocrinology field. Healio: Why has thyroid eye disease management traditionally fallen more to ophthalmolo gists rather than endocrinologists? Hoang: Historically, medical therapy for thyroid eye disease was very limited and nonspecific. Usually, we just offered steroids either orally or intravenously. That is why thyroid eye disease management just defaulted to ophthalmologists, largely because, at that time, they would perform surgery like orbital decompression, strabismus surgery or eyelid surgery. I am a little bit unique. I received my training in the military system at the Walter Reed National Military Medical Center. In our medical center, we as endocrinologists collaborate very closely with the ophthalmologist. But with any medical therapy, we are the ones who prescribe and initiate treatment. Whether that is rituximab or teprotumumab, we are writing the prescription. Then, we are comanaging with the ophthalmologist. The ophthalmologist and oculoplastic surgeon can do the ocular measurements for the patient, and they can follow along at baseline and during the treatment. If the patient requires any surgery, the ophthalmologist or oculoplastic surgeon can perform surgery after the medical treatment. You can see the landscape has changed now. In the past, the thinking was that for very severe thyroid eye disease, you need to perform surgery. But now with new medical treatments available, that landscape has changed. That is why it is important to educate the clinician about this. Healio: Can you highlight some of the reasons you feel endocrinologists should take the lead with thyroid eye disease management? Hoang: Graves’ disease is an autoimmune process. Thyroid eye disease happens mostly in patients with Graves’ disease. Endocrinologists are already seeing these patients with Graves’ disease, and thyroid eye disease can develop before and even after a Graves’ disease diagnosis. Mostly, thyroid eye disease emerges while the patient is already under endocrine care. That is why endocrinologists should take charge of it. They should not wait until advanced eye disease before acting. Endocrinologists should screen for risk for thyroid eye disease, especially in older patients, patients who are smokers and those who undergo radioactive iodine. Endocrinologists should recognize early signs and symptoms for these patients and educate them. I usually tell my patients that if they have any eye symptoms at all, like double vision, blurred vision, grittiness, dry eyes, excessive tearing, any swelling, pain, redness or photophobia, they should contact me and I’ll refer them quickly to see the ophthalmologist because some of these symptoms can progress very rapidly. From an endocrine perspective, our role has several key parts: Ensure the patient is receiving appropriate therapy and that thyroid levels are normalized. Recognize that fluctuating or uncontrolled thyroid levels can worsen thyroid eye disease. Initiate disease-modifying treatment when indicated. Coordinate multidisciplinary care to support timely, comprehensive management. Healio: How important is it to have relationships with ophthalmologists so you can refer patients when needed? Hoang: Endocrinologists already see these patients in our clinics. I think we can take advantage of that and serve as the clinical anchor by coordinating care with the ophthalmologist, the oculoplastic surgeon, strabismus specialist, radiation oncologist, audiologist and other primary care physician when appropriate. This team-based approach structure can help ensure the comprehensive care of thyroid eye disease across the disease spectrum, including medical treatment during the active and chronic inflammation, and monitoring for any treatment response or relapse for our patient. Right now, it takes about 3 to 5 years for patients to be diagnosed with thyroid eye disease, and you fall out of the window to treat them effectively. Collaboration shortens diagnostic delay, reduces fragmentation in care for your patient and improves patient outcomes. You need to have an infrastructure referral pathway. When it comes building the referral partnership, for me, at a large medical center, that starts with reaching out to ophthalmologists introducing ourselves and developing professional relationships. Close, trusted partnerships can help endocrinologists and eye specialists align on care decisions, close communication gaps and build confidence for both clinicians and patients. Ultimately, that collaboration can improve patient care. Healio: How can the healthcare community pivot toward making endocrinologists more of an anchor for managing thyroid eye disease? Hoang: Making endocrinologists the anchor of thyroid eye disease care will require a coordinated combination of clinical practice guideline reinforcement and targeted education. We can provide education sessions for endocrinologists and endocrine practitioners. We can use AI tools to help with the structured referral pathways and thyroid eye disease screening. That may make it easier for endocrinologists to feel more engaged with thyroid eye disease and multidisciplinary care infrastructure. Education and training are essential. Endocrinologists need practical training in how to confidently examine patients for thyroid eye disease and assess disease severity. As a program director, I have seen wide variation in exposure to thyroid eye disease management among fellows, trainees and even staff. Some have limited experience, while others have much more. Standardized education can close those gaps, promote more consistent thyroid eye disease care and ultimately improve patient outcomes. For more information: Thanh D. Hoang, DO, MACP, FACE, can be reached at [email protected]; Facebook @HoangDucThanh; LinkedIn @ThanhHoang.