Hyperthyroid vs hypothyroid eye disease: the same severity and activity

Kashkouli, Mohsen Bahmani; Pakdel, Farzad; Kiavash, Victoria; Heidari, Iraj; Heirati, Abtin; Jam, Sara

doi:10.1038/eye.2011.186

Cited by 34 publications

(33 citation statements)

References 28 publications

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“…Upon comparing the other clinical and demographic features of hypo- and hyperthyroid orbitopathy, it was observed that hypothyroid orbitopathy occurred more frequently in females ( P = 0.059) which was in keeping with previous studies. [ 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

Clinical profile of thyroid eye disease and factors predictive of disease severity

Muralidhar

Das

Tiple

2020

Indian J Ophthalmol

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Purpose: To describe the clinical features of thyroid eye disease (TED) in patients presenting at a tertiary eye care centre in North India and to identify factors predictive of severe disease. Methods: This observational cross-sectional study involved clinical evaluation of all patients with TED who presented at the oculoplastic clinic based on the ITEDS VISA proforma. Risk factors for the severe disease were assessed using univariate and multivariate logistic regression. Results: A total of 106 patients (50 males, 56 females; mean age 41.30 ± 14.76 years) were identified during the study period, 46.23% hyperthyroid, 33.96% hypothyroid and 19.81% euthyroid. The proportion of the patients with hypothyroid was higher as compared with prior studies and most patients with hypothyroid had the mild disease (63.89%). Orbitopathy symptoms were the presenting feature leading to the diagnosis of systemic thyroid abnormality in 25% of the patients with hypothyroid and 59.18% of the patients with hyperthyroid, respectively ( P < 0.05). Eyelid and orbitopathy signs were more common in the patients with hyperthyroid (51.2% and 87.7%) as compared with hypothyroid where the commonest presenting symptoms were related to dry eye (50.1%). Active disease was seen in 22.6% of the patients. Mild, moderate to severe and sight-threatening disease was seen in 54.7%, 37.7% and 7.5%, respectively. On multivariate analyses, hyperthyroid status and activity was associated with severe disease. Smoking was not associated with activity or severity. Conclusion: There is no significant difference in the gender profile of the patients with TED in this cohort. The patients with hypothyroid have a milder disease compared to the patients with hyperthyroid, and dry eye symptoms are the commonest presenting symptoms in hypothyroid subjects. Hyperthyroidism and activity were associated with severe and sight-threatening disease.

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Section: Discussionmentioning

confidence: 99%

Clinical profile of thyroid eye disease and factors predictive of disease severity

Muralidhar

Das

Tiple

2020

Indian J Ophthalmol

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“…The activity of TED was similar between patients with either hyper or hypothyroidism in the present study, which paralleled the results of previous research. 21 It has been found that the severity and activity of TED are often dissimilar among different populations. For example, an investigation of 346 patients that classified patients according to EUGOGO reported no TED in 73.7%, mild and inactive TED in 20.2%, and moderate-to-severe and active TED in 5.8%.…”

Section: Discussionmentioning

confidence: 99%

The epidemiological characteristics of patients with thyroid eye disease in a referral center in northern Iran

Medghalchi

Akbari

Alizadeh

et al. 2018

Journal of Current Ophthalmology

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PurposeThis study was conducted to determine the demographics, clinical features, severity, and activity of thyroid eye disease (TED) in patients of a referral center in the north of Iran.MethodsPatients with TED who were referred to Amir-Almomenin Hospital, Rasht, Iran from March 2012 to March 2014 were enrolled in this cross-sectional study. The measurements of proptosis, lid width, lagophthalmos, extraocular muscle function, and visual acuity were recorded. The activity of ophthalmopathy was scored according to the clinical activity score (CAS).ResultsTED was diagnosed in 103 patients with a mean age of 42.1 ± 13.91 years. Of those patients, 52.4% were women, and 80% had hyperthyroidism. The mean duration of TED was 36.5 ± 53.12 months. Extraocular muscle involvement (98%) and eyelid retraction (88.3%) were the most common manifestations. Per the CAS results, 86 (83.5%) patients were at stage 0, and there was a significant difference in CAS scores between male and female patients, P = 0.02.ConclusionsThe characteristics of TED in patients of the studied referral center during a two-year period, including common signs and symptoms, disease duration, treatment, an activity of disease were determined. Notably, many patients in this study had orbital squeal of TED meaning that they had inactive TED. Proper management of this serious complication requires close cooperation between endocrinologists and ophthalmologists to ensure timely referrals for appropriate care.

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“…Finally, after discarding 25 articles for different reasons (all the patients had hyperthyroidism, did not present ophthalmopathy, or it was not possible to determine the prevalence) 14 articles met all the inclusion criteria, but two articles had the same sample because they were made in the same population. To avoid overrepresentation of this cross-sectional study, we included only the data of one of them [ 22 , 23 ] (Fig. 1 ) (Additional file 3 ).…”

Section: Resultsmentioning

confidence: 99%

Prevalence of hyperthyroidism, hypothyroidism, and euthyroidism in thyroid eye disease: a systematic review of the literature

et al. 2020

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Background: Thyroid eye disease is an autoimmune disorder of the orbital retrobulbar tissue commonly associated with dysthyroid status. The most frequent condition is hyperthyroidism, although it is also present in hypothyroid and euthyroid patients. The prevalence of thyroid conditions in patients with thyroid eye disease had been previously evaluated; however, there is no consensus on a global prevalence. The study aims to estimate the prevalence of hyperthyroidism, hypothyroidism, and euthyroidism in patients with TED, through a systematic review of literature. Methods: We conducted a systematic review of the literature following the PRISMA guidelines, in MEDLINE, COCHRANE, EMBASE, Science Direct, and LILACS databases. Inclusion criteria were primary studies of patients with a diagnosis of thyroid eye disease made by an ophthalmologist or with diagnosis criteria, with measurement of thyroid function (TSH, T3, and free T4), and diagnosis of the primary thyroid condition. A quality assessment was made through the Joanna Briggs Institute Quality tools. Finally, we extracted relevant details about the design, the results, and the prevalence of thyroid disorders in thyroid eye disease. Results: The initial search revealed 916 studies, of which finally thirteen met inclusion criteria. Six studies were performed in Europe (Germany, Wales, and Spain), five in Asia (Iran, South Korea, Japan, and Singapore), one in North America (USA), and one in Africa (Ghana). The global prevalence, in patients of thyroid eye disease, was 10.36% for hypothyroidism, 7.9% for euthyroidism, and 86.2% for hyperthyroidism. Conclusions: Professionals should be aware that thyroid eye disease can be present in patients with a normal thyroid function. The assessment for these patients is based on orbital images; serum TSH, T3, and free T4; antibody levels as thyrotropin receptor antibodies; and thyroperoxidase levels. Additionally, we want to encourage research in this field in other regions of the world such as Latin America.

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Hyperthyroid vs hypothyroid eye disease: the same severity and activity

Cited by 34 publications

References 28 publications

Clinical profile of thyroid eye disease and factors predictive of disease severity

Clinical profile of thyroid eye disease and factors predictive of disease severity

The epidemiological characteristics of patients with thyroid eye disease in a referral center in northern Iran

Prevalence of hyperthyroidism, hypothyroidism, and euthyroidism in thyroid eye disease: a systematic review of the literature

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