Which of the following does NOT occur in Thyroid Eye Disease?

Which of the following does NOT occur in Thyroid Eye Disease?

• A. Fibroblast proliferation leading to swelling of EOMs
• B. EOM belly inflammation
• C. EOM tendon inflammation
• D. Hyperthyroidism

Answer: (D)

Thyroid Eye Disease is an autoimmune process in the orbit that drives inflammation and edema within the extraocular muscles through activation of orbital fibroblasts and infiltration by inflammatory cells, leading to muscle enlargement and swelling of the orbital contents. This is why fibroblast proliferation causing swelling of the extraocular muscles and inflammation in the muscle bellies are features you’d expect to see in the disease. Hyperthyroidism, on the other hand, is a systemic thyroid state often associated with Graves’ disease, and while many patients with Graves’ may be hyperthyroid, that thyroid condition is not an ocular finding of Thyroid Eye Disease. The eye disease itself reflects the local inflammatory and fibrotic changes in the orbit, not the thyroid hormone status. Therefore, hyperthyroidism does not occur as part of the ocular disease process.

Thyroid Eye Disease is an autoimmune process in the orbit that drives inflammation and edema within the extraocular muscles through activation of orbital fibroblasts and infiltration by inflammatory cells, leading to muscle enlargement and swelling of the orbital contents. This is why fibroblast proliferation causing swelling of the extraocular muscles and inflammation in the muscle bellies are features you’d expect to see in the disease.

Hyperthyroidism, on the other hand, is a systemic thyroid state often associated with Graves’ disease, and while many patients with Graves’ may be hyperthyroid, that thyroid condition is not an ocular finding of Thyroid Eye Disease. The eye disease itself reflects the local inflammatory and fibrotic changes in the orbit, not the thyroid hormone status. Therefore, hyperthyroidism does not occur as part of the ocular disease process.