zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2019-16-1-2zdor-88Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESСОВРЕМЕННЫЙ ВЗГЛЯД НА ЭТИОЛОГИЮ И ПАТОГЕНЕЗ ЭНДОКРИННОЙ ОФТАЛЬМОПАТИИModern View on the Etiology and Pathogenesis of Endocrine OphthalmopathyСадовскаяО. П.SadovskayaO. P.noemail@neicon.ruДравицаЛ. В.DravitsaL. V.noemail@neicon.ruУчреждение образования «Гомельский государственный медицинский университет»Belarus20192803201901914Copyright © Садовская О.П., Дравица Л.В., 20192019Садовская О.П., Дравица Л.В.Sadovskaya O.P., Dravitsa L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/88

Эндокринная офтальмопатия (ЭОП) - аутоиммунная прогрессирующая патология, в большинстве случаев протекающая на фоне болезни Грейвса (БГ), реже - при аутоиммунном тиреоидите и при эутиреозе без признаков заболевания щитовидной железы. Несмотря на наличие доказанной взаимосвязи между патологией щитовидной железы и ЭОП, механизмы патогенеза изучены недостаточно. В статье освещены современные теории этиопатогенеза, генетической предрасположенности к развитию ЭОП, факторы риска, особенности клинического течения и основные осложнения данной патологии. ЭОП может стать причиной значительного снижения остроты зрения, утраты профессиональной трудоспособности и инвалидности, поэтому только междисциплинарный подход, своевременная диагностика и лечение позволят избежать осложнений и сохранить качество жизни пациентов.

Endocrine ophthalmopathy (EOP) is an autoimmune progressing pathology, which in most cases is associated with Graves’ disease (GD), but also occurs in patients with autoimmune thyroiditis and euthyroidism without symptoms of thyroid disease. Despite the existence of the proven interconnection between thyroid pathology and EOP, the mechanisms of its pathogenesis have not been studied completely. The article covers the modern theories of etiology and pathogenesis, genetic predisposition to the development of EOP, the risk factors, features of the clinical course and major complications of this pathology. EOP may cause significant loss of visual acuity and lead to disability, so only the multidisciplinary approach, timely diagnosis and treatment may prevent the complications and preserve the quality of life of patients.

эндокринная офтальмопатияболезнь Грейвсакомпрессионно-ишемическая оптиконейропатияглаукомаendocrine ophthalmopathyGraves' diseasecompression ischemic optic neuropathyglaucomaReferencesMaheshwari R, Weis E. Thyroid Associated Orbitopathy. Indian J of Ophthalmology. 2012;60:87-93.doi: 10.4103/0301-4738.94048.Maheshwari R, Weis E. Thyroid Associated Orbitopathy. Indian J of Ophthalmology. 2012;60:87-93.doi: 10.4103/0301-4738.94048.Carballo MCS, de Sá BPC, Rocha DRTW, Arbex AK. (2017) Pathophysiology of Graves’ Ophthalmopathy: A Literature Review. Open J of Endocrine and Metabolic Diseases. 2017;7(1):77-87. doi: 10.4236/ojemd.2017.71008.Carballo MCS, de Sá BPC, Rocha DRTW, Arbex AK. (2017) Pathophysiology of Graves’ Ophthalmopathy: A Literature Review. Open J of Endocrine and Metabolic Diseases. 2017;7(1):77-87. doi: 10.4236/ojemd.2017.71008.Gleeson H, Kelly W, Toft A, Dickinson J, Kendall TP. Severe thyroid eye disease associated with primary hypothyroidism and thyroid-associated dermopathy. Thyroid. 1999; 9(11):1115-1118.doi: 10.1089/thy.1999.9.1115.Gleeson H, Kelly W, Toft A, Dickinson J, Kendall TP. Severe thyroid eye disease associated with primary hypothyroidism and thyroid-associated dermopathy. Thyroid. 1999; 9(11):1115-1118.doi: 10.1089/thy.1999.9.1115.Burch HB, Wartofsky L. Graves’ Ophthalmopathy: current concepts regarding pathogenesis and management. Endocr Rev. 1993; 14:747-793. doi: 10.1210/edrv-14-6-747.Burch HB, Wartofsky L. Graves’ Ophthalmopathy: current concepts regarding pathogenesis and management. Endocr Rev. 1993; 14:747-793. doi: 10.1210/edrv-14-6-747.Bartalena L, Pinchera A, Marcocci C. Management of Graves’ ophthalmopathy: Reality and perspectives. Endocr Rev.2000;21:168-99. doi: 10.1210/edrv.21.2.0393.Bartalena L, Pinchera A, Marcocci C. Management of Graves’ ophthalmopathy: Reality and perspectives. Endocr Rev.2000;21:168-99. doi: 10.1210/edrv.21.2.0393.Tellez M, Cooper J, Edmonds C. Graves’ ophthalmopathy in relation to cigarette smoking and ethnic origin. Clin Endocrinol (Oxf).1992;36:291-4.Tellez M, Cooper J, Edmonds C. Graves’ ophthalmopathy in relation to cigarette smoking and ethnic origin. Clin Endocrinol (Oxf).1992;36:291-4.Brovkina AF. `Endokrinnaj aoftalmopatija. Moskva, RF: GEOTAR-MED; 2004. 176 р. (in Russ.)Brovkina AF. `Endokrinnaj aoftalmopatija. Moskva, RF: GEOTAR-MED; 2004. 176 р. (in Russ.)Likhvantseva VG., Korosteleva EV, Kovelenova IV., Budanov SV, Ben Rezh Amin. Deficit glaznogo krovotoka - klyuchevoj faktor, opredelyayushchij formu vtorichnoj glaukomy pri ehndokrinnoj oftal'mopatii. Rus Ophthalmological Journ. 2016; 9(3):43-49. doi: 10.1016/0014-4835(92)90793-r. (in Russ.)Likhvantseva VG., Korosteleva EV, Kovelenova IV., Budanov SV, Ben Rezh Amin. Deficit glaznogo krovotoka - klyuchevoj faktor, opredelyayushchij formu vtorichnoj glaukomy pri ehndokrinnoj oftal'mopatii. Rus Ophthalmological Journ. 2016; 9(3):43-49. doi: 10.1016/0014-4835(92)90793-r. (in Russ.)Khong JJ, Finch S, De Silva C, Rylander S, Craig JE, Selva D, Ebeling PR. Risk Factors and Clinical Characteristics of GO. J Clin Endocrinol Metab. 2016;101(7):2711-2720. doi: 10.1210/jc.2015-4294.Khong JJ, Finch S, De Silva C, Rylander S, Craig JE, Selva D, Ebeling PR. Risk Factors and Clinical Characteristics of GO. J Clin Endocrinol Metab. 2016;101(7):2711-2720. doi: 10.1210/jc.2015-4294.Wiersinga WM, Kahaly GJ, editors. Graves’ Orbitopathy: A Multidisciplinary Approach: questions and answers. 2nd ed. Basel, Switzerland: Karger; 2007. 285 p.Wiersinga WM, Kahaly GJ, editors. Graves’ Orbitopathy: A Multidisciplinary Approach: questions and answers. 2nd ed. Basel, Switzerland: Karger; 2007. 285 p.Wiersinga WM, Bartalena L. Epidemiology and prevention of Graves’ ophthalmopathy. Thyroid. 2002;12:855-860. doi: 10.1089/105072502761016476.Wiersinga WM, Bartalena L. Epidemiology and prevention of Graves’ ophthalmopathy. Thyroid. 2002;12:855-860. doi: 10.1089/105072502761016476.Sviridenko NYu, Lihvanceva VG, Belovalova IM, SHeremeta MS, Tabeeva KI. Antitela k receptoru TTG kak prediktory tyazhestii iskhodov ehndokrinnoj oftal'mopatii u pacientov s bolezn'yu Grejvsa. Probl Ehndokrinologii. 2011;2:23-26. (in Russ.)Sviridenko NYu, Lihvanceva VG, Belovalova IM, SHeremeta MS, Tabeeva KI. Antitela k receptoru TTG kak prediktory tyazhestii iskhodov ehndokrinnoj oftal'mopatii u pacientov s bolezn'yu Grejvsa. Probl Ehndokrinologii. 2011;2:23-26. (in Russ.)Carballo MCS, de Sa BPC, Rocha DRTW, Arbex AK. Pathophysiology of Graves’Ophthalmopathy: A Literature Review. Open J of Endocrine and Metabolic Diseases. 2017;7:77-87. doi: 10.4236/ojemd.2017.71008.Carballo MCS, de Sa BPC, Rocha DRTW, Arbex AK. Pathophysiology of Graves’Ophthalmopathy: A Literature Review. Open J of Endocrine and Metabolic Diseases. 2017;7:77-87. doi: 10.4236/ojemd.2017.71008.Stan MN, Bahn RS. Risk Factors for Development or Deterioration of Graves’ Ophthalmophaty. Thyroid. 2010;20:777-783. doi: 10.1089/thy.Stan MN, Bahn RS. Risk Factors for Development or Deterioration of Graves’ Ophthalmophaty. Thyroid. 2010;20:777-783. doi: 10.1089/thy.Harincev VV, Serkin DM, Serebryakova OV, Harinceva SV. Znachenie nekotoryh rostovyh faktorov v patogeneze ehndokrinnoj oftal'mopatii. Klin i Ehksperimental'naya Tireoidologiya. 2017;3(1):12-19. doi: 10.14341/ket2017112-19. (in Russ.)Harincev VV, Serkin DM, Serebryakova OV, Harinceva SV. Znachenie nekotoryh rostovyh faktorov v patogeneze ehndokrinnoj oftal'mopatii. Klin i Ehksperimental'naya Tireoidologiya. 2017;3(1):12-19. doi: 10.14341/ket2017112-19. (in Russ.)Lihvanceva VG, Kuz'min VA, Korostelyova VE, Solomatina MV, Budanova SV. Poisk i identifikaciya receptorov tireoidnyh gormonov v tkanyah glaza. Oftal'mologiya. 2014;11(2):27-30. doi: 10.18008/1816-5095-2014-4. (in Russ.)Lihvanceva VG, Kuz'min VA, Korostelyova VE, Solomatina MV, Budanova SV. Poisk i identifikaciya receptorov tireoidnyh gormonov v tkanyah glaza. Oftal'mologiya. 2014;11(2):27-30. doi: 10.18008/1816-5095-2014-4. (in Russ.)Şahlı E. Thyroid-associated Ophthalmopathy. Turk J Ophthalmol. 2017;47:94-105. doi: 10.4274/tjo.80688.Şahlı E. Thyroid-associated Ophthalmopathy. Turk J Ophthalmol. 2017;47:94-105. doi: 10.4274/tjo.80688.Likhvantseva VG, Kharlap SI, Korosteleva EV, et al. Contribution of hemodynamic disturbances in magistral vessels to optic neuropathy progression and ocular tension changes in endocrine ophthalmopathy. Annals of Ophthalmology. 2015;131(4):32-37. (in Russ.)Likhvantseva VG, Kharlap SI, Korosteleva EV, et al. Contribution of hemodynamic disturbances in magistral vessels to optic neuropathy progression and ocular tension changes in endocrine ophthalmopathy. Annals of Ophthalmology. 2015;131(4):32-37. (in Russ.)Acharya SH, Avenell A, Philip S, Burr J, Bevan JS, Abraham P. Radioiodine therapy for Graves’ disease and the effect on ophthalmopathy-a systematic review. Clin Endocrinol (Oxf). 2008;69:943-950 doi: 10.1111/j.1365-2265.2008.03279.x.Acharya SH, Avenell A, Philip S, Burr J, Bevan JS, Abraham P. Radioiodine therapy for Graves’ disease and the effect on ophthalmopathy-a systematic review. Clin Endocrinol (Oxf). 2008;69:943-950 doi: 10.1111/j.1365-2265.2008.03279.x.Saakyan SV, Panteleeva OG, Sirmajs OS. Osobennosti klinicheskogo techeniya ehndokrinnoj oftal'mopatii v detskom vozraste. Ros Pediatr Oftal'mologiya. 2014;3:20-23. (in Russ.)Saakyan SV, Panteleeva OG, Sirmajs OS. Osobennosti klinicheskogo techeniya ehndokrinnoj oftal'mopatii v detskom vozraste. Ros Pediatr Oftal'mologiya. 2014;3:20-23. (in Russ.)

The authors declare that there are no conflicts of interest present.