Ethnic differences in the clinical presentation of Graves’ ophthalmopathy

Chng, Chiaw Ling; Seah, Lay Leng; Khoo, D. H. C.

doi:10.1016/j.beem.2011.10.004

Cited by 57 publications

(46 citation statements)

References 87 publications

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“…Chng et al suggested that while Asians suffer less severe features of TED compared to Caucasians, their orbital anatomy may predispose them to optic neuropathy more readily. 15 Tsai et al observed that the mean exophthalmometry values for adult Chinese Graves' disease patients in Taiwan (18.32 mm) tend to be lower than those of Caucasians and Black-American people, but are close to those of Korean, Japanese, Iranian, Indian, and Asian-American people. 16 However, there is a lack of literature that looks specifically at ethnic differences in pediatric TED.…”

Section: Discussionmentioning

confidence: 91%

Pediatric Thyroid Eye Disease—The Singapore Experience

Lim

Amrith

Sundar

2013

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Clinical manifestations in pediatric TED are relatively mild and respond well to conservative therapy. Orbital decompression is rarely required but may be considered in children with severe proptosis. Mean exophthalmometry values are lower in East-Asian pediatric TED as compared to Caucasians. Symptomatic acquired epiblepharon, usually associated with keratopathy, is commonly seen in East-Asian pediatric TED; thus, increased awareness among ophthalmologists and pediatricians should be emphasized.

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Section: Discussionmentioning

confidence: 91%

Pediatric Thyroid Eye Disease—The Singapore Experience

Lim

Amrith

Sundar

2013

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“…Polymorphisms in immunomodulatory genes have been reported to be associated with GO, including genes encoding cytotoxic T lymphocyte antigen (CTLA-4), interleukin-1 (IL-1) and members of the IL-1 family, interferon (IFN)γ, IL-23R, CD40, protein tyrosine phosphatase, non-receptor type 22 (PTPN22), nuclear factor-kappa B (NF-κB) and tumor necrosis factor α (TNFα) (77), as well as thyroid specific genes (TSH receptor gene) and adipogenesis-related genes, such as peroxisome proliferator-activated receptor γ (PPARγ). These findings are based on small case-controlled association studies and suggest racial differences in genetic associations (41). These results, however, require confirmation in large-scale studies.…”

Section: Risk Factorsmentioning

confidence: 90%

“…Anatomical differences between races: Racial differences in ocular anatomy in normal subjects and GO patients have been extensively reviewed (40,41). Normal exophthalmometry values vary significantly among races, with Asians having low values and blacks having relatively shallow orbits and higher values (42)(43)(44)(45).…”

Section: Clinical Presentationmentioning

confidence: 99%

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Graves' Ophthalmopathy: Epidemiology and Natural History

et al. 2014

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Graves' ophthalmopathy (GO) is an autoimmune disorder of the orbit that is clinically relevant in 25-50% of patients with Graves' disease and 2% of patients with chronic thyroiditis. The age-adjusted annual incidence of clinically relevant GO is 16 per 100,000 population in women and 2.9 in men. At the onset of ophthalmopathy, 80-90% of patients have hyperthyroidism, with the rest having euthyroidism or hypothyroidism. The natural history of GO consists of two phases: an active inflammatory phase and a static phase. Antiinflammatory therapy is indicated for the first phase of GO. Approximately 5% of patients experience late reactivation of GO. Asians appear to have less severe manifestations, with milder orbital edema, proptosis and muscle restriction. Genetic, anatomic and environmental factors influence the development of GO. Aging, thyroid dysfunction, thyroid stimulating hormone (TSH) receptor antibodies, smoking and radioiodine treatment for hyperthyroidism also influence the development and course of GO.

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“…Suele iniciarse entre la tercera y cuarta décadas de vida. Su presentación clínica puede ser más severa en ancianos y en hombres, y más leve en asiáticos 2,3 .…”

Section: Introductionunclassified