ArticleThyroid : official journal of the American Thyroid Association2014
Spontaneous improvement of untreated mild Graves' ophthalmopathy: Rundle's curve revisited.
Article in Thyroid : official journal of the American Thyroid Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers.
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Who cites it
46 citing papers in PubMed.
- Randomized controlled trial of rituximab in patients with Graves' orbitopathy.The Journal of clinical endocrinology and metabolism · 2015Trial
- Markers of fibrosis in orbital tissues from patients graves' orbitopathy: a retrospective cohort study.Journal of endocrinological investigation · 2026Article
- Case Report: Teprotumumab treatment in an HIV-infected patient with refractory thyroid eye disease: clinical and quantitative MRI evidence.Frontiers in immunology · 2026Article
- The efficacy of radiotherapy for steroid-resistant thyroid eye disease: clinical outcomes in orbital inflammation and exophthalmos.Radiation oncology journal · 2025Article
- Selenium vs Control for Graves Ophthalmopathy in a Selenium-Sufficient Area: A Randomized Clinical Trial.JAMA ophthalmology · 2025Article
- Asymmetry Upper Eyelid Retraction of Thyroid Eye Disease: Change of Lateral Flare Sign With the Natural Course of Untreated Disease.Scientifica · 2025Article
- The burden of illness in thyroid eye disease: current state of the evidence.Frontiers in ophthalmology · 2025Review
- Efficacy of Tocilizumab in Refractory Graves Orbitopathy From Real-World Clinical Practice: An Observational Study.Journal of the Endocrine Society · 2024Article
- Predictive model for the progression of inactive thyroid eye disease: a retrospective study.Endocrine · 2024Article
- Effect of Intraorbital Mechanical Compression on Retinal Microvascular Perfusion in Quiescent Thyroid-Associated Ophthalmopathy Based on Ocular Biomechanics Measured by Corvis ST.Ophthalmology and therapy · 2024Article
- Evaluation of disease-specific quality of life and its influencing factors in Bulgarian patients with Graves' orbitopathy.International ophthalmology · 2024Article
- Changes in therapeutic response, ocular manifestations of Graves' orbitopathy and quality of life during the first year after orbital radiotherapy.International ophthalmology · 2023Article
- McKittrick-Wheelock syndrome presenting with presumed paraneoplastic syndrome extra-ocular muscle enlargement masquerading as thyroid eye disease.Endocrinology, diabetes & metabolism case reports · 2023Article
- Serelaxin Alleviates Fibrosis in Thyroid-Associated Ophthalmopathy via the Notch Pathway.International journal of molecular sciences · 2023Article
- Thyrotropin Receptor Autoantibody Assessment in Thyroid Eye Disease: Does the Assay Type Matter?Korean journal of ophthalmology : KJO · 2023Article
- Assessment of Choroidal Vascularity in Inactive Thyroid Associated Orbitopathy.Beyoglu eye journal · 2023Article
- Analysis of macular blood flow changes in thyroid associated ophthalmopathy.BMC ophthalmology · 2022Observational
- Differential Circular RNA Expression Profiling of Orbital Connective Tissue From Patients With Type I and Type II Thyroid-Associated Ophthalmopathy.Investigative ophthalmology & visual science · 2022Article
- Current concepts regarding Graves' orbitopathy.Journal of internal medicine · 2022Review
- Longitudinal association of thyroid-stimulating immunoglobulin levels with clinical characteristics in thyroid eye disease.BMJ open · 2022Observational
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Abstract
backgroundAccording to Rundle's curve, Graves' ophthalmopathy (GO) worsens during an initial phase up to a peak of maximum severity, then improves and reaches a static plateau, with the activity curve preceding the severity curve by a few months. To our knowledge, no studies have tried to replicate Rundle's curve, and very few have investigated the natural history of GO. Here, we studied GO natural history retrospectively and tried to identify factors that may affect it.
methodsA total of 65 patients with untreated GO underwent an eye assessment after a median of seven months after the appearance of GO and then after a median of 40 months. The primary endpoints were the variation of the single GO features and of the NOSPECS score, as well as the overall outcome of GO. The secondary endpoint was the influence of several variables (age, sex, smoking, GO and thyroid disease duration, thyroid treatment, thyroid status, thyroid volume, anti-TSH receptor autoantibodies) on the outcome of GO.
resultsThe majority of patients had mild, minimally active GO, and only five had a Clinical Activity Score (CAS) >3. There was a significant reduction of CAS (p<0.0001) and NOSPECS (p=0.01) between the first and last observation, with a timing pattern resembling Rundle's curve. This difference was confirmed even when patients with a CAS >3 at first observation were excluded. At the last observation, 50.8% of patients had improved, 33.8% had remained stable, and 15.4% had worsened moderately or substantially. The overall outcome of GO was not affected by any of the variables under examination.
conclusionsIn confirmation of Rundle's observations, untreated GO improves spontaneously with time in the majority of patients, with an activity peak between 13 and 24 months, which may have implications in determining the proper timing of GO treatments.
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