Open Journal of Endocrine and Metabolic Diseases, 2017, 7, 77-87 http://www.scirp.org/journal/ojemd ISSN Online: 2165-7432 ISSN Print: 2165-7424 DOI: 10.4236/ojemd.2017.71008 January 17, 2017 Pathophysiology of Graves’ Ophthalmopathy: A Literature Review Mariela Carolina Santos Carballo 1 , Bianca Paiva Cunha de Sá 1 , Denise Rosso Tenório Wanderley Rocha 1 , Alberto Krayyem Arbex 1,2 1 Division of Endocrinology, IPEMED Medical School, São Paulo, Brazil 2 Diabetology Department, Malteser Krankenhaus St. Franziskus-Hospital, Flensburg, Germany Abstract Graves’ ophthalmopathy (GO), an autoimmune condition associated with Graves’ disease (GD), occurs at a prevalence of nearly 40% in patients diag- nosed with GD. Ocular involvement is probably due to the presence of au- toantibodies in the orbital tissues, regardless of the control state of thyroid hormones in individuals with GD, even during euthyroid or hypothyroid states, which are associated with thyroid hormone treatment. In addition to the immunological role present in the pathophysiology of GO, the genetic component, proteins and cytokines, minerals (e.g., selenium), and environ- mental factors (e.g., smoking) also contribute to its development and occur- rence of clinical manifestations in varying degrees. Until now, the interaction of causal, intermediary, and triggering factors of GO is still unclear, so the purpose of this article is to review literature on the theme. Keywords Ophthalmopathy, Graves Disease, Pathophysiology 1. Introduction Graves’ ophthalmopathy (GO), an autoimmune condition associated with Graves’ disease (GD), occurs at a prevalence of nearly 40% in patients diagnosed with GD [1] [2] [3] [4]. It is usually seen in people who have had GD for some time, and thus are also likely to be included in a more advanced age group than those who do not present with ocular changes. GO is more common in women, often associated with autoimmune disease, and has an incidence of 16.3 per 100,000 people/year. According to Tellez et al., the risk of developing GO is 6.4 times higher in the European population than that in the Asian population. Se- vere cases of GO represent 3% - 5% of all cases and are more severe in men [1] How to cite this paper: Carballo, M.C.S., de Sá, B.P.C., Rocha, D.R.T.W. and Arbex, A.K. (2017) Pathophysiology of Graves’ Ophthalmopathy: A Literature Review. Open Journal of Endocrine and Metabolic Dis- eases, 7, 77-87. http://dx.doi.org/10.4236/ojemd.2017.71008 Received: November 11, 2016 Accepted: January 14, 2017 Published: January 17, 2017 Copyright © 2017 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access