The Multidisciplinary Approach Of Graves Ophthalmopathy Management - A Source Of Competitiveness Of The Medical Tourism In Romania

Chronic diseases have become a major health issue in Europe and the management of these diseases is very complex and include major costs for high performance imagistic investigations and treatment. Because health insurances cover less medical services, health tourism in Romania has become attractive for patients from western Europe, due to lower costs of treatment and the professionality of the medical staff. The Graves disease is a condition with multisystemic character , that affects all the organs and systems of the body and needs a multidisciplinary approach for its management. Graves’ ophthalmopathy (GO), the most common extrathyroidal manifestation of Graves’ disease, is considered a constellation of signs and symptoms resulting from chronic autoimmune-related orbital inflammation, which inevitably influences the quality of life of affected patients, thus being a real problem of debate with multidisciplinary therapeutic approach. Imaging studies of the orbit detect extraocular muscle or fat enlargement in 90% of adults with Graves hyperthyroidism, therefore MRI being an irreplaceable tool in delineating the stage of the disease and the course of treatment. The therapeutic management of GO is focused on three main aspects: smoking cessation, restoring and maintaining euthyroidism, and speciffc treatment of eye changes. Whereas the mild form of GO requires only protective local measures, moderate and severe forms request a complex approach including medical treatment, radiotherapy or orbital decompression. Taking into account all these aspects, the management of GO should never be undertaken by the endocrinologist or by the ophthalmologist acting alone and for a proper approach of the disease, it should be a strong collaboration between the endocrinologist, the ophthalmologist and the radiologist.