These results do suggest that the eye changes and thyroid autoimmunity do not run in parallel as one would expect if the two features were part of the same disease, that is, “Graves' disease” or “Hashimoto disease.” Thus, the development of ophthalmopathy in patients with thyroid autoimmunity may depend on the presence of additional risk factors such as smoking [17, 18] and genetic factors such as the recently identified CSQ1 polymorphism rs384216 [19]. This evidence concerns the gene CASQ1 and autoimmune thyroid disease.