Euthyroid Graves' Ophthalmopathy With Negative Antibodies (EGONA): A Comprehensive Case-Based Review

Euthyroid Graves' ophthalmopathy with negative antibodies (EGONA) is a rare form of thyroid eye disease. This literature review aims to establish the different presentations seen in the cases of euthyroid Graves' ophthalmopathy with negative antibodies. Despite the thyroid levels being normal, the mechanism by which EGONA causes eye disease is the same as the classical Graves' ophthalmopathy. Proper diagnosis relies mainly on clinical signs and imaging of the eye. A systematic search of PubMed, PubMed Central, and ScienceDirect was conducted with no date restrictions. Articles were included if they were English-language case reports describing patients with euthyroid ophthalmopathy and negative thyroid antibodies during initial presentation, with full-text availability and a documented clinical course. Data from nine articles (12 cases) were extracted, focusing on presentation, management, and outcomes. Treatments include corticosteroids, anti-thyroid medication, and surgery. Prognosis varied between those who developed thyroid imbalances and the presence of antibodies later down the course.