NEURO-OPHTHALMOLOGY: Edited by Dean M. CestariThyroid eye disease what is new to know?Li, Zhena; Cestari, Dean M.b; Fortin, ElizabethbAuthor Information aDepartment of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, China bNeuro-Ophthalmology Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA Correspondence to Zhen Li, MD, PhD, Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. Tel: +86 13581646689; E-mail: [email protected] Current Opinion in Ophthalmology: November 2018 - Volume 29 - Issue 6 - p 528-534 doi: 10.1097/ICU.0000000000000529 Buy Metrics Abstract Purpose of review The pathophysiology of thyroid eye disease (TED) is still not fully understood. However, recently described risk factors and molecular findings have brought new insights into the mechanisms of TED and could lead to the emerging use of more targeted therapies. This article aims to review the clinical findings of TED, and the most recent advances in our understanding of the risk factors and therapeutic options for TED. Recent findings Smoking has been recently shown to have an impact on specific gene expression involved in several disease-related pathways, which seems to be reversible with smoking cessation. This finding further emphasizes the importance of smoking cessation in the prevention and treatment of TED. Selenium deficiency and high-serum cholesterol have been described to be potential independent risk factors for TED and their management could decrease the incidence and severity of TED. In terms of therapeutic options, immunomodulatory medications have shown some promising results for disease control in TED over the past years, but further randomized prospective studies with larger sample sizes are still needed to prove their efficacy. A new technique of 32P brachytherapy was shown to have quick therapeutic effects on TED without significant side effects and could be a promising therapy for selected cases of TED. Summary TED is one of the most common autoimmune inflammatory disorders of the orbit. Although its pathophysiology remains unclear, newly described genetic findings and risk factors could help in explaining its occurrence and guide future therapies. Immunosuppressant medications are increasingly used in the management of TED, but further studies are needed to confirm their effectiveness. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.