Demographic and clinical profile of 1000 patients with thyroid eye disease presenting to a Tertiary Eye Care Institute i
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ORIGINAL PAPER
Demographic and clinical profile of 1000 patients with thyroid eye disease presenting to a Tertiary Eye Care Institute in India Milind N. Naik
. Varshitha Hemanth Vasanthapuram
Received: 17 May 2020 / Accepted: 17 August 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To assess the demographic and clinical profile of thyroid eye disease (TED) presenting to a Tertiary Eye Care Institute in India. Methods All patients who were diagnosed to have TED between the year 2007 and 2017 at the Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, were included in this retrospective observational study. The demographic details of parameters such as age, gender and laterality, presenting signs and symptoms, clinical activity at presentation, and systemic thyroid status were assessed. Results A total of 1000 consecutive patients of TED were evaluated in the 10-year period. Average age at presentation was 44.9 years (range 8–89). Of the 1000, 529 (53%) were males, and 358 (36%) had unilateral TED. At presentation, the TED was active (time since onset B 12 months) in 476 (48%) cases and 71 (7%) had dysthyroid optic neuropathy. Of the 913 patients where systemic thyroid status was available at the time of presentation, 342 (37%) were euthyroid at presentation. Of the patients who were
Meeting presentation: Poster presentation at the Annual Meeting of the International Thyroid Eye Disease Society, February 21–23, 2019, Singapore. M. N. Naik (&) V. H. Vasanthapuram Ophthalmic Plastic Surgery Service, L.V. Prasad Eye Institute, Hyderabad, India e-mail: [email protected]
active at presentation (n = 476), 349 (70.3%) were ‘Silent presenters’ (Active as per timeline, but CAS B 3). A prominent eye was the most common presenting symptom in 563 (64%) patients. Presenting signs in order of frequency were proptosis in 582 (58%), lower lid retraction (49%), upper lid retraction (48%), strabismus (6%), ptosis (5.5%), and corneal ulcer (1.3%). Conclusions TED in India presents to the tertiary eye center with slight male preponderance. One-third (37%) are euthyroid and half (48%) are active at presentation. One-third (35%) are silent presenters, with minimal clinical activity during the active phase of TED. Keywords Thyroid eye disease Graves’ ophthalmopathy Epidemiology Proptosis
Introduction Graves’ disease is an autoimmune disorder characterized by thyroid gland hyperplasia and excessive production of thyroid hormones [1]. Involvement of the eye, also known as Graves’ Ophthalmopathy or thyroid eye disease (TED), is the most-common extrathyroidal manifestation of Graves’ disease [2]. TED results from infiltration of the orbital soft tissues with auto-reactive T lymphocytes, proliferation of
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orbital fibroblasts, and increased adipocytes [3]. Clinically recognizable TED has been reported to occur in 25–50% of Graves’ Disease patients, and sight-threatening disease in 3–5% cases in the western literature [4]. Environmental and geneti
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