{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:40:09Z","timestamp":1786650009900,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Thyroid stimulating hormone, T3, T4, and thyroid auto-antibodies are essential in diagnosis of immune thyroiditis, Graves\u2019 and Hashimoto\u2019s. These, however, may not correlate with thyroid eye disease or TED. In recent years, a new blood test for thyroid stimulating immunoglobulins (TSI) is in use. However, there is no sufficient clinical evidence of their role in TED. The purpose of the current study is to evaluate the correlation between TSI and TED activity and to examine if TSI is a predictor for the severity of the disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis of electronic medical records of all patients who attended TED clinic at Sheba Medical Center, Israel between 2017 and 2022 and had at least one TSI sample was performed. Data included demographics, comprehensive ophthalmic examination, clinical activity scores (CASs), laboratory tests, and quality of life assessment by the Graves\u2019 Orbitopathy QOL questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      60 patients with 43 females (72%) were included. TSI at presentation correlated with eyelid retraction, IOP (Pearson correlation, 0.369, P&lt; =0.01), and CAS (Pearson correlation, 0.392,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.029). TSI values &gt;500% were found to be significantly correlated with the use of medical treatment including high-dose steroids (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.05), steroid treatment according to the European Group on Graves\u2019 Orbitopathy protocol (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), and radioactive iodine (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.03). Moreover, it was also significantly correlated with surgical procedures including decompression (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.016) and strabismus surgeries (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.024).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>TSI is correlated with more severe clinical presentation and higher likelihood of medical or surgical treatment. Therefore, TSI can be considered as a predictor factor for the disease. Routing testing for TSI may be warranted for all TED patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1035_24","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T15:00:10Z","timestamp":1767020410000},"page":"129-132","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Thyroid-stimulating immunoglobulins as a reliable predictive blood test for thyroid eye disease"],"prefix":"10.4103","volume":"74","author":[{"given":"Shiran","family":"Madgar","sequence":"first","affiliation":[{"name":"Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy Ben","family":"Simon","sequence":"additional","affiliation":[{"name":"Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayelet","family":"Priel","sequence":"additional","affiliation":[{"name":"Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oded","family":"Sagiv","sequence":"additional","affiliation":[{"name":"Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphna","family":"Landau-Prat","sequence":"additional","affiliation":[{"name":"Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tali","family":"Cukierman-Yaffe","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel"},{"name":"Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel-Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Agmon-Levin","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel"},{"name":"Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronen","family":"Shavit","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel"},{"name":"Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lital","family":"Smadar","sequence":"additional","affiliation":[{"name":"Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofira","family":"Zloto","sequence":"additional","affiliation":[{"name":"Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1056\/NEJMra0905750","article-title":"Graves\u2019 ophthalmopathy","volume":"362","author":"Bahn","year":"2010","journal-title":"N Engl J Med"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1056\/NEJM200010263431707","article-title":"Graves\u2019 disease","volume":"343","author":"Weetman","year":"2000","journal-title":"N Engl J Med"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/BF03345269","article-title":"TSH receptor expression in orbital tissue and its role in the pathogenesis of Graves\u2019 ophthalmopathy","volume":"27","author":"Bahn","year":"2004","journal-title":"J Endocrinol Invest"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1016\/j.ophtha.2011.03.030","article-title":"Clinical relevance of thyroid-stimulating immunoglobulins in Graves\u2019 ophthalmopathy","volume":"118","author":"Ponto","year":"2011","journal-title":"Ophthalmology"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.cca.2021.06.017","article-title":"Evaluation of the application of TSH receptor stimulating autoantibodies and the optimization of detection strategy in Graves\u2019 disease","volume":"521","author":"Tong","year":"2021","journal-title":"Clin Chim Acta"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1046\/j.1365-2265.1997.2331047.x","article-title":"Clinical activity score as a guide in the management of patients with Graves\u2019 ophthalmopathy","volume":"47","author":"Mourits","year":"1997","journal-title":"Clin Endocrinol (Oxf)"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1530\/EJE-07-0666","article-title":"Consensus statement of the European Group on Graves\u2019 orbitopathy (EUGOGO) on management of GO","volume":"158","author":"Bartalena","year":"2008","journal-title":"Eur J Endocrinol"},{"key":"R8-20260420","first-page":"8","article-title":"Thyroid autoimmunity: Role of anti-thyroid antibodies in thyroid and extra-thyroidal diseases","author":"Fr\u00f6hlich","year":"2017","journal-title":"Front Immunol.Frontiers Media S.A."},{"key":"R9-20260420","first-page":"e19448","article-title":"Elevated Graves\u2019 Disease-Specific Thyroid-Stimulating Immunoglobulin and Thyroid Stimulating Hormone Receptor Antibody in a Patient With Subacute Thyroiditis","volume":"13","author":"Alvin Mathew","year":"2021","journal-title":"Cureus"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1007\/s10792-021-02052-0","article-title":"Diagnostic accuracy of Immulite\u00ae TSI immunoassay for thyroid-associated orbitopathy in patients with recently diagnosed Graves\u2019 hyperthyroidism","volume":"42","author":"Thia","year":"2022","journal-title":"Int Ophthalmol"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1007\/s40618-018-0945-6","article-title":"Usefulness of TSH receptor antibodies as biomarkers for Graves\u2019 ophthalmopathy: A systematic review","volume":"41","author":"Seo","year":"2018","journal-title":"J Endocrinol Invest"},{"key":"R12-20260420","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1210\/jc.2009-2470","article-title":"A novel thyroid stimulating immunoglobulin bioassay is a functional indicator of activity and severity of Graves\u2019 orbitopathy","volume":"95","author":"Lytton","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"R13-20260420","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s40618-015-0254-2","article-title":"Thyroid-stimulating immunoglobulins indicate the onset of dysthyroid optic neuropathy","volume":"38","author":"Ponto","year":"2015","journal-title":"J Endocrinol Invest"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"e050337","DOI":"10.1136\/bmjopen-2021-050337","article-title":"Longitudinal association of thyroid-stimulating immunoglobulin levels with clinical characteristics in thyroid eye disease","volume":"12","author":"Ko","year":"2022","journal-title":"BMJ Open"},{"key":"R15-20260420","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/j.eprac.2022.07.007","article-title":"Thyroid-Stimulating Antibody\/Thyroid-Stimulating Hormone Receptor Antibody Ratio as a Sensitive Screening Test for Active Graves\u2019 Orbitopathy","volume":"28","author":"Nakano","year":"2022","journal-title":"Endocr Pract"},{"key":"R16-20260420","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1016\/j.ophtha.2011.03.030","article-title":"Clinical relevance of thyroid-stimulating immunoglobulins in Graves\u2019 ophthalmopathy","volume":"118","author":"Ponto","year":"2011","journal-title":"Ophthalmology"},{"key":"R17-20260420","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1507\/endocrj.EJ19-0398","article-title":"Role of a new bioassay for thyroid-stimulating antibodies (aequorin TSAb) in Graves\u2019 ophthalmopathy","volume":"67","author":"Hiromatsu","year":"2020","journal-title":"Endocr J"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_1035_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:01:01Z","timestamp":1786647661000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_1035_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,29]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_1035_24","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,29]]},"assertion":[{"value":"2024-05-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}