Consensus statement of the European Group on Graves' orbitopathy (EUGOGO) on management of GO

TLDR

The consensus recommends that patients with Graves' orbitopathy be referred to specialist centers, encouraged to quit smoking, and receive prompt treatment to restore and maintain euthyroidism. Treatment is stratified by severity: sight‑threatening disease receives intravenous glucocorticoids with urgent decompression if needed; moderate‑to‑severe active disease is treated with IV glucocorticoids (± orbital radiation) and surgery considered when inactive; mild disease is managed with local measures and observation, reserving treatment for significant quality‑of‑life impact. The document is dedicated to the memory of Mark Prummel, a founder of EUGOGO.

Abstract

Summary of consensus a. 1):Be referred to specialist centers;Be encouraged to quit smoking;Receive prompt treatment in order to restore andmaintain euthyroidism.b. Patients with sight-threatening GO should be treatedwith i.v. GCs as the first-line treatment; if the responseis poor after 1–2 weeks, they should be submitted tourgent surgical decompression.c. The treatment of choice for moderate-to-severe GO isi.v. GCs (with or without OR) if the orbitopathy isactive;surgery(orbitaldecompression,squintsurgery,and/or eyelid surgery in this order) should beconsidered if the orbitopathy is inactive.d. In patients with mild GO, local measures and anexpectant strategy are sufficient in most cases, buttreatment may be justified if QoL is affectedsignificantly. In memoriam This document is dedicated to the memory of MarkPrummel (1956–2005), one of the founders ofEUGOGO, who greatly contributed to expanding ourunderstanding of clinical and therapeutic aspects of GO.