Thyroid Eye Disease Clinic offers customized, collaborative approach to treatment

April 27, 2023

Thyroid eye disease (TED) — also known as Graves' orbitopathy, Graves' ophthalmopathy and thyroid-associated orbitopathy — requires multispecialty evaluation with the involvement of endocrinologists, ophthalmologists and ENT surgeons for optimal management. The team at Mayo Clinic's Thyroid Eye Disease (TED) Clinic has developed a seamless, collaborative approach that offers customized and efficient treatment.

"The TED Clinic model has aided in streamlining diagnostic processes and treatment recommendations," says Lilly H. Wagner, M.D., an ophthalmologist at Mayo Clinic in Rochester, Minnesota. "This method delivers leading expertise, while also providing patients peace of mind as they return home to continue their coordinated care with their local physicians."

At the TED Clinic, all Mayo Clinic specialties involved in the evaluation of each patient converge to provide a coordinated approach. The patient's individual evaluations are combined into one summary assessment and management plan.

The TED Clinic patients are seen in the morning in individual consultations by each of the specialties involved. Their cases are then discussed at a conference where patients' photographs and laboratory data are reviewed. The team of physicians assesses disease activity, severity and modifiable risk factors. A common plan of action is agreed upon, which is then presented to the patient in an afternoon follow-up visit that same day.

Marius N. Stan, M.D., an endocrinologist at Mayo Clinic in Rochester, Minnesota, explains: "In most cases, these patients used to be seen by multiple specialties from separate practices with appointments scattered over weeks to months. Given the expected fluctuations in the disease, the ability to coordinate a collaborative and comprehensive evaluation within one day in the TED Clinic provides a customized, efficient approach."

This model provides an assessment and recommended plan of therapy that also can be coordinated with a patient's medical team at home. Through detailed notes and direct communication, Mayo Clinic specialists collaborate with local physicians and discuss how to implement the recommended therapies and surgical options.

Improving outcomes and quality of life

TED Clinic specialists at Mayo Clinic are committed to research that optimizes outcomes, reduces side effects and improves patients' quality of life.

Dr. Wagner explains, "The collaborative nature of our clinic allows us to see the disease as a whole — helping us to identify current gaps in treatment and understand what research could have the most impact and value for patients."

About 100 new patients per year have a multidisciplinary evaluation in the TED Clinic. The clinic's collaborative approach provides a unique opportunity to help identify individuals who would be candidates for alternative medications or qualify to participate in clinical trials.

"Historically, there were limited medications to offer patients who have this disease," explains Dr. Stan. "Over the past few years, we've identified a new medication, teprotumumab, which may benefit patients who would not typically qualify to receive it."

Mayo Clinic is also in the beginning stages of studying the long-term impacts of current treatments. While the majority of industry trials focus on symptom reduction, researchers within the TED Clinic are working to identify measurable parameters for patients' quality of life and the effect of receiving treatment from a multidisciplinary team.

Dr. Wagner explains: "Multidisciplinary research is an essential part of our clinic because it leads to a deeper understanding of the disease — enabling the development of innovative and improved forms of therapy for this debilitating condition."