The Amsterdam declaration


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THE AMSTERDAM DECLARATION

GRAVES’ ORBITOPATHY: IMPROVING OUTCOMES FOR

THYROID EYE DISEASE

On the 30th of October several professional medical societies and patient-led organisations joined forces in signing the Amsterdam Declaration. The ceremony took place during the 10th International Symposium on Graves’ orbitopathy (Figure 1).

The Amsterdam Declaration (Table 1) is about improving care for people with thyroid eye disease focusing on early diagnosis and intervention, collaborative research and education.

In total 68 cosignatories (14 international professional societies, 43, national professional societies, 11 patient-led organisations) have thus far supported the Amsterdam Declaration (Table 2).

For further information on the Amsterdam Declaration contact Dr Petros Perros petros.perros@nuth.nhs.uk.


TABLE 1

Graves’ orbitopathy: improving outcomes for Thyroid eye disease

The Amsterdam Declaration 2009

Graves’ orbitopathy affects hundreds of thousands of people in the world every year. It causes pain, discomfort, double vision, disfigurement and sometimes blindness. People suffering with Graves’ orbitopathy have a poor quality of life and long-term psychosocial morbidity. The quality of care received by the majority of people affected by this condition can be improved. Conventional treatments are effective when used appropriately and by centres with expertise. Not all patients are offered effective treatments either because most are not referred early or not at all. People at high risk of developing Graves’ orbitopathy can be identified and effective risk management can potentially lessen the severity of the disease.

The care of people with Graves’ orbitopathy can be improved vastly by making centres of excellence more accessible to them.

In October 2009, international experts on Graves’ orbitopathy, representatives of professional organisations and patient representatives met in Amsterdam and unanimously agreed on the following:

Health care providers and professional organisations should recognise the need to improve the care of people with Graves’ orbitopathy and support plans for implementing better care and prevention.

The general objectives are:

  • to minimise the morbidity associated with Graves’ orbitopathy and improve the patients’ experience and quality of life
  • prevent the development of Graves’ orbitopathy in people at high risk

The 5-year targets are:

  • Raise awareness of this condition among health care professionals and managers
  • Establish pathways of referral and care
  • Support existing centres of excellence in management of this condition
  • Create new centres of excellence in localities where they are lacking
  • Establish audit and monitoring mechanisms of quality assurance of provision of care to people with Graves’ orbitopathy
  • Implement measures to reduce the incidence and morbidity of the disease by
    • halving the time from presentation to diagnosis
    • halving the time from diagnosis to referral to a centre of excellence
    • appropriate management of thyroid dysfunction including use of radioiodine
    • vigorous anti-smoking measures in patients at risk of or with Graves’ orbitopathy
  • Improve the existing research networks and develop further international collaborative research



TABLE 2

Cosignatories of the Amsterdam Declaration

International professional societies

  • Academia Ophthalmologica Europea
  • Academia Ophthalmologica Internationalis
  • American Thyroid Association
  • Asia Pacific Society of Ophthalmic Plastic and Reconstructive Surgery
  • European Association for Vision and Eye Research (EVER)
  • Endocrine Society
  • European Group on Graves’ Orbitopathy
  • European Society of Endocrinology
  • European Society of Orbital Plastic Reconstructive Surgery
  • European Thyroid Association
  • Iberico-American Society of Ophthalmic Plastic and Orbital Surgery
  • International Thyroid Eye Disease Study Group
  • Latin-American Thyroid Society
  • World Society of Pediatric Ophthalmology and Strabismus (WSPOS)


National professional societies

  • All India Ophthalmological Society
  • American Association of Clinical Endocrinologists
  • Argentina Council of Ophthalmology
  • Argentina Society of Ophthalmology
  • Belgian Endocrine Society
  • Belgian Thyroid Club
  • Bielschowsky-Gesellschaft für Schielforschung und Neuroophthalmologie
  • British Oculoplastic Surgery Society
  • British Thyroid Association
  • Chinese Society of Ophthalmology
  • Cyprus Endocrine Society
  • Danish Thyroid Association
  • Dutch Endocrine Society
  • Finnish Endocrine Society
  • French Endocrine Society
  • French Society of Ophthalmic Plastic Reconstructive and Aesthetic Surgery
  • German Endocrine Society
  • German Thyroid Board
  • German Society of Ophthalmology
  • Hellenic Endocrine Society
  • Italian Association of Medical Endocrinologists
  • Italian Society of Endocrinology
  • Italian Society of Ophthalmic Plastic Surgery
  • Italian Thyroid Association
  • Irish Endocrine Society
  • Japan Thyroid Association
  • Japanese Society of Ophthalmology
  • Macedonian Endocrine Association
  • Oculoplastic Association of India
  • Ophthalmological Society of Portorico
  • Philippine Society of Ophthalmic Plastic and Reconstructive Surgery
  • Philippine Academy of Ophthalmology
  • Polish Thyroid Society
  • Romanian Society for Endocrinology
  • Royal College of Ophthalmologists (UK)
  • Serbian Endocrine Society
  • Slovak Endocrine Society
  • Società Oftalmologica Italiana
  • Society for Endocrinology (UK)
  • South African Society of Oculoplastic Surgeons
  • Spanish Society of Ophthalmic Plastic and Orbital Surgery
  • Swiss Endocrine and Diabetes Society
  • Turkish Society for Endocrinology and Metabolism


Thyroid patient associations

  • Association Vivre sans Thyroïde
  • British Thyroid Foundation
  • Finnish Thyroid Foundation
  • Italian Thyroid Patient Association
  • Nederlandse Vereniging van Graves’ Patiënten
  • Schildklierstichting Nederland
  • Svenska Sköldkörtel Föreningen
  • Thyroid Eye Disease charitable trust (UK)
  • Thyroid Federation International
  • Verein Schilddrüsengruppe Schweiz
  • United States of America Graves’ Disease Foundation


 
 

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