Exophthalmos in Autoimmune Thyroid Disease*

Abstract

Protrusion of the eyes of patients with autoimmune thyroid disease was compared with that of healthy subjects. The mean values for protrusion in patients with thyrotoxic Graves' disease and Hashimoto's disease and in healthy subjects were 16.6 +/- 2.1 mm (mean +/- SD; n = 122), 14.2 +/- 1.8 mm (n = 100), and 13.9 +/- 1.9 mm (n = 558), respectively. The value of Graves' disease was significantly different from that for healthy subjects (P < 0.001). Individual values for protrusion showed a similar normal distribution in these three groups, but were displaced to higher values as a whole in Graves' disease. These results, which suggest that almost all patients with Graves' disease have exophthalmos, do not support the idea that Graves' ophthalmopathy is a distinct single autoimmune disease.

Exophthalmos of patients with Graves' disease in Chinese of Taiwan

“…Amino also reported that the mean values for protrusion in patients with thyrotoxic GD (16.672.1 mm) were greater than in healthy subjects (14.271.8 mm). 20 The distribution pattern of exophthalmos in our GD adults was similar to normal population but just shifted to higher values. This is in agreement with other previous studies.…”

“…In comparison with previous studies of normal subjects among different populations, the normal exophthalmos value for the Chinese in Taiwan obtained from our study seemed to be lower than that of both black and white people in the United States, [3][4][5][6] Danish, 1,2 and Mexican; 17 but is close to that of Indian, 18 Korean, 19 and Japan. 20 If the upper normal limit was defined as 2 standard deviations above the mean, the upper limit of normal Chinese in our study was 18.6 mm, which was lower than 21 mm that has traditionally been considered for Caucasians. Migliori and Gladstone 4 reported the upper limit of normal value was 20.1 mm for white women, 21.7 mm for white men, 23.0 mm for black women, and 24.7 mm for black men, which all were so different from what has been reported of the others 17.7 mm for the Japanese, 20 18.3 mm for Koreans, 19 19.3 mm for Iranians, 21 and 18.6 mm for the present study.…”

“…20 If the upper normal limit was defined as 2 standard deviations above the mean, the upper limit of normal Chinese in our study was 18.6 mm, which was lower than 21 mm that has traditionally been considered for Caucasians. Migliori and Gladstone 4 reported the upper limit of normal value was 20.1 mm for white women, 21.7 mm for white men, 23.0 mm for black women, and 24.7 mm for black men, which all were so different from what has been reported of the others 17.7 mm for the Japanese, 20 18.3 mm for Koreans, 19 19.3 mm for Iranians, 21 and 18.6 mm for the present study. The clinical significance is that an Asian patient with exophthalmometric reading within the upper normal limit of Caucasian measurements may consider advanced study to exclude TAO or other cause of exophthalmos.…”

“…This is in agreement with other previous studies. 20,11 Diagnosis of the eye disease as GO is difficult in unilateral exophthalmos, particularly if they are in an euthyroid state. However, GO is still the most important differential diagnosis in adult patients with unilateral exophthalmos.…”

Valores da exoftalmometria média na população adulta da região do Grande ABC, São Paulo/Brasil

“…No entanto, esse limite varia conforme a população estudada: japoneses (17,7mm) (20) , coreanos (18,3mm) (7) , iranianos (19,3mm) (21) , e chineses (18,6mm) (15) . Observou-se neste estudo um limite superior de 20mm para os brancos e os pardos, e de 23mm para o grupo dos negros.…”