Describe the progression of inflammatory orbitopathy and the biological progression of patients receiving second-line treatment (immunosuppressants, radiotherapy, or biotherapy).

Inclusion Criteria:

• Patients aged 18 and older with moderate to severe orbitopathy;
• Patients followed in endocrinology with the goal of achieving euthyroidism;
• Corticosteroid-resistant patients: patients who have received at least 3 weeks of treatment with 500 mg weekly corticosteroid boluses and have not shown improvement in the clinical activity score (CAS);
• Corticosteroid-dependent patients: relapse with a CAS of 3 or higher when decreasing or stopping corticosteroid therapy;
• Patients with a CAS ≥ 3 or CAS <3 with moderate to severe orbitopathy (according to EUGOGO);
• Patients treated with immunotherapy, biotherapy, or radiotherapy as second-line treatment;
• Patients who are not opposed to the reuse of their health data.

Exclusion Criteria:

• Patients who have undergone bone or fat decompression surgery;
• Patients with severe corneal involvement (Grade B or C; NO SPECS classification);
• Patients with optic neuropathy (Grade B and C; NO SPECS classification);
• Patients who have received 1 gram corticosteroid boluses for dysthyroid orbitopathy;
• Patients who have opposed the reuse of their health data.

The data collection concerns patients with Graves' orbitopathy who have received corticosteroid treatment and second-line treatment (immunosuppressants, biotherapy) since 2015, 2021, or 2022. A decision was made to limit the inclusion to patients who started second-line treatment between January 2022 and December 2023, with clinical follow-up until the end of 2024, in order to limit selection bias and ensure an adequate follow-up period.

The inclusion period extends until June 2025.

Each center remains the owner of its data, so it is possible to extract and send data from each center via the eCRF for theses or publications