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Nora Dehina Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin
Department of Ophthalmology, University Hospital Essen, Essen, Germany

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Peter Josef Hofmann Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin

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Thomas Behrends Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin

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Anja Eckstein Department of Ophthalmology, University Hospital Essen, Essen, Germany

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Lutz Schomburg Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin

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and symptoms are patient-specific and may include protruding eye balls (exophthalmos), facial disfigurement, double vision, retrobulbar pain and/or headache [ 3 ]. In rare cases, extrathyroidal manifestations like pretibial myxedema may develop. The

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Luigi Bartalena Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Wilmar M. Wiersinga Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

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appearance score (from 51 to 55, NS) after orbital decompression for dysthyroid optic neuropathy (DON); in contrast, after decompression for disfiguring exophthalmos, the change in visual functioning score was not significant (from 64.8 to 68.0, NS), whereas

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Kenneth Ka Hei Lai Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China

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Fatema Mohamed Ali Abdulla Aljufairi Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
Department of Ophthalmology, Salmaniya Medical Complex, Government Hospitals, Bahrain

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Jake Uy Sebastian Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
Department of Ophthalmology, Vicente Sotto Memorial Medical Center, Cebu City, Philippines

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Yingying Wei Department of Statistics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China

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Ruofan Jia Department of Statistics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China

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Karen Kar Wun Chan Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong Special Administrative Region, China

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Elaine Yuen Ling Au Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong Special Administrative Region, China

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Alan Chun Hong Lee Division of Endocrinology and Metabolism, Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China

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Chiu Ming Ng Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, China

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Hunter Kwok Lai Yuen Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
Hong Kong Eye Hospital, Hong Kong Special Administrative Region, China

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Wilson Wai Kuen Yip Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong Special Administrative Region, China

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Alvin Lerrmann Young Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong Special Administrative Region, China

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George Pak Man Cheng Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China

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Clement Chee Yung Tham Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
Hong Kong Eye Hospital, Hong Kong Special Administrative Region, China

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Chi Pui Pang Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China

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Kelvin Kam Lung Chong Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
Hong Kong Eye Hospital, Hong Kong Special Administrative Region, China

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failure to reach the midline (−4 to −1 for an excursion in 25% increments) ( 20 ). Exophthalmos was measured by the Hertel exophthalmometer ( 21 ). Eyelid positions were documented using margin reflex distance (MRD): MRD1 was defined as the distance

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Luigi Bartalena Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy

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the fibroadipose tissue and the infiltration (with an increased volume) of extraocular muscles in a rigid anatomic site like the orbit make clinical manifestations of GO (exophthalmos, extraocular muscle dysfunction, congestion of periorbital soft

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Mahdi Kamoun Endocrinology and Metabolism Department

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Michèle d'Herbomez Department of Nuclear Medicine, Lille University Hospital, Lille

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Christine Lemaire Department of Endocrinology, Regional Hospital of Béthune, Béthune

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Armelle Fayard Endocrinology and Metabolism Department

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Rachel Desailloud Endocrinology and Metabolism Department, Amiens University Hospital, Amiens, France

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Damien Huglo Department of Nuclear Medicine, Lille University Hospital, Lille

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Jean-Louis Wemeau Endocrinology and Metabolism Department

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hyperthyroid. Her blood pressure was 130/70 mm Hg, and her pulse was regular at 88 bpm. Her height was 150 cm, body weight 46 kg, with a BMI of 20.4. She had a small, homogeneous and vascular goiter. Examination of her eyes showed mild bilateral exophthalmos

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Elena Sabini Endocrinology Units, Department of Clinical and Experimental Medicine, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Marenza Leo Endocrinology Units, Department of Clinical and Experimental Medicine, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Barbara Mazzi Endocrinology Units, Department of Clinical and Experimental Medicine, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Roberto Rocchi Endocrinology Units, Department of Clinical and Experimental Medicine, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Francesco Latrofa Endocrinology Units, Department of Clinical and Experimental Medicine, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Marco Nardi Ophthalmopathy Unit I, Department of Surgical, Medical and Molecular Pathology, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Paolo Vitti Endocrinology Units, Department of Clinical and Experimental Medicine, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Claudio Marcocci Endocrinology Units, Department of Clinical and Experimental Medicine, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Michele Marinò Endocrinology Units, Department of Clinical and Experimental Medicine, University of Pisa and University Hospital of Pisa, Pisa, Italy

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[ 14 - 18 ], but patients may have constitutional or myopic exophthalmos that may not be distinguishable from GO exophthalmos. The issue of GO disappearance was investigated in two previous studies, but none of them considered disappearance of GO from

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Luigi Bartalena University of Insubria, Varese, Italy

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negative impact on the quality of life of affected individuals ( 2 ) because of its disfiguring (exophthalmos) and dysfunctional (diplopia) features and can only partially be prevented by intervening to change modifiable risk factors ( 3 ). In the large

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Jun Yang Department of Nuclear Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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Meng-Jie Dong Department of Nuclear Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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Qin Xu Department of Nuclear Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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and high rate of recurrence. A 53-year-old Chinese man was admitted to our hospital in December 2012 because he presented a 14-year history of uncontrolled hyperthyroidism. The exophthalmos and dermopathy were not observed. The patient does not

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Elena Sabini Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Ilaria Ionni Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Roberto Rocchi Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Paolo Vitti Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Claudio Marcocci Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Michele Marinò Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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approximately 6 months later due to further eye deterioration. Signed informed consent was obtained. At physical examination he had an exophthalmos in his right eye, with eyelid edema and chemosis, and diplopia in the upper and upper-right gaze (Fig.  1 ). The

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Pauline Campredon Department of Endocrinology and Metabolic Diseases, Larrey University Hospital, Toulouse, France

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Philippe Imbert Ophthalmologist, Clinique du Parc, Toulouse, France
Multidisciplinary Thyroid Eye Consultation, Department of Endocrinology, Larrey University Hospital, Toulouse, France

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Céline Mouly Department of Endocrinology and Metabolic Diseases, Larrey University Hospital, Toulouse, France

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Solange Grunenwald Department of Endocrinology and Metabolic Diseases, Larrey University Hospital, Toulouse, France

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Julien Mazières Department of Pneumology, Larrey University Hospital, Toulouse, France

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Philippe Caron Department of Endocrinology and Metabolic Diseases, Larrey University Hospital, Toulouse, France

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processes, IgG4-related orbitopathy (IgG4 = 0.67 g/L, normal range 0.03–1.31 g/L), orbital cellulitis, or metastases. Fig. 2. a Axial CT scan showing severe exophthalmos after nivolumab treatment, with severe proptosis of both orbits with fat

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