Do I Need a Multidisciplinary TED Clinic?
People with mild, inactive TED may do well with local care, as long as their endocrinologist and ophthalmologist communicate effectively, French says.
A specialty clinic is most worth considering when TED is active, moderate to severe, fast-changing, or possibly sight-threatening. It may also be helpful if you have double vision, eye movement problems, significant bulging, vision changes, active inflammation, or possible surgery needs.
“Patients who benefit most from multidisciplinary TED clinics are those with active, moderate-to-severe or sight-threatening disease, where coordinated endocrine–ophthalmic decisions directly affect outcomes,” says French.
French says closer monitoring and integrated decision-making may be especially important for people at higher risk for severe or progressive TED, including:
- Men
- Older adults
- People who smoke
- People with diabetes
- People with elevated TRAb, or thyroid-stimulating hormone receptor antibodies, a blood marker linked with Graves’ disease and TED activity
If you can’t get to a multidisciplinary clinic, ask your doctors to coordinate with one another as much as possible. French recommends direct communication between endocrinology and ophthalmology so key details — including thyroid status, clinical activity score, thyroid receptor antibody levels, risk factors, and planned treatments — are shared accurately. (A clinical activity score is a tool doctors use to rate how active the eye inflammation is.)
“Scheduling endocrine and eye visits close together around major decisions, such as immunotherapy, radioiodine, teprotumumab monitoring, or surgery planning, can also help keep care aligned,” says French.
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