Prevalence and risk factors of thyroid-associated ophthalmopathy among Indians

Mathur, Chetan; Singh, Shailendra Pratap; Sharma, Saurabh

doi:10.18203/2349-3933.ijam20162513

Cited by 3 publications

(5 citation statements)

References 16 publications

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“…Several literatures had shown that type II diabetes mellitus had a higher incidence of thyroid dysfunction. [17][18][19] This is similar to our study but we couldn't elicit significant association between co-morbidities such as diabetes mellitus, hypertension, cardiovascular disease and myasthenia gravis. Slight losses due to optic neuropathy was 6% to 34% observed in several literature 5,20 .…”

Section: Discussionsupporting

confidence: 88%

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Prevalence of Thyroid Eye Disease in Patients With Thyroid Dysfunction in a Tertiary Care Hospital of Central Nepal

Dahal,

Khatiwada,

Lamichhane

et al. 2023

JCMC

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Background: Thyroid eye disease is the most common extra thyroidal manifestation of Graves’ disease. The pattern and prevalence of thyroid eye disease vary widely from a mild disorder characterized by dry eye symptoms and ocular irritation to a severe disfiguring form of orbitopathy. Thyroid eye disease is a frequently encountered Ophthalmological morbidity in Nepal and across the globe. The aim of this study was to ascertain the prevalence of thyroid eye disease in subjects with thyroid dysfunction in a tertiary care hospital in central Nepal.. Methods: This was a prospective cross-sectional study, conducted in Chitwan medical college Teaching hospital (CMCTH), department of Ophthalmology. Subjects presenting to Ophthalmology department or referred patients from different departments with thyroid dysfunction were enrolled in the study. The data thus collected was analyzed using SPSS version 26 and the data was presented as frequency and percentage. Results: Among 320 subjects screened for Thyroid eye disease prevalence, 106 (33.3%) were hyperthyroid, 207 (64.7%) were hypothyroid whereas, 7 (2.2%) were euthyroid. The prevalence of Thyroid eye disease was 40% and this was more prevalent among hypothyroid. Among the 320 patients with thyroid eye disease, 126 (39.4%), 95 (29.7%), 53 (16.6%), 24 (7.5%), 15 (4.7%), 5 (1.6%) and 2 (0.6%) had CAS score of 1,2,3,4,5,6 and 7 respectively. Similarly, NOSPECS score (American Thyroid Association) 243 (75.9%), 57 (17.8%), 1 (0.3%), 7 (2.2%), 8 (2.5%), 3(0.9%) and 1 (0.3%) were graded from 0-6 accordingly respectively. Conclusions: Thyroid eye disease was more prevalent in hypothyroid middle-aged females and the overall prevalence of Thyroid Eye disease was more in hypothyroid patients. Though sight threatening complications didn’t exist in our study, close workup by endocrinologist and ophthalmologist can decrease ocular morbidity.

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Section: Discussionsupporting

confidence: 88%

“…Mathur, et al also showed that patient with a severe course of disease had a higher CAS score. 19 NOSPECS was independent risk factor for thyroid eye disease. 10 NOSPECS score 0 was present in 243 (75.9%) patients.…”

Section: Discussionmentioning

confidence: 87%

Prevalence of Thyroid Eye Disease in Patients With Thyroid Dysfunction in a Tertiary Care Hospital of Central Nepal

Dahal,

Khatiwada,

Lamichhane

et al. 2023

JCMC

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“…Mathur et al . [ 35 ] found smoking, male gender, and higher CAS to be associated with severe GO. Lat et al .…”

Section: Discussionmentioning

confidence: 99%

Factors associated with severity of orbitopathy in patients with Graves' disease

Nabi¹,

Rafiq

2020

Taiwan J Ophthalmol

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PURPOSE: Graves' orbitopathy (GO) is one of the most frequent orbital disorders and is the most common cause of proptosis in adults. GO is described as chronic inflammation of orbital and periorbital tissues. This study aimed to evaluate the risk factors for severe GO in patients with Graves' disease (GD). MATERIALS AND METHODS: This was a prospective cross-sectional study done on 52 newly diagnosed patients of GD with GO documented by thyroid 99m Technetium-pertechnetate scan at our center between May 2016 and May 2019. All patients underwent a comprehensive ophthalmological examination and laboratory and hormonal analysis. Clinical Activity Score (CAS) and severity were estimated as per the European Group on Graves Orbitopathy. Thirty-four patients with mild GO were compared with 18 patients with moderate-to-severe GO (severe) for baseline risk parameters. RESULTS: Majority of the patients had mild orbitopathy (34 [65.4%]) followed by moderate to severe (18 [34.6%]). CAS was active in 13.5% of the study group. There was a statistically significant male preponderance in severe GO. Current smoking increased the risk of severe GO ( P = 0.003). Duration of GD symptoms at presentation was statistically significantly longer in severe GO patients than mild GO ( P = 0.004). Thyrotropin receptor antibody (TRAb) titer significantly increased in severe GO group (6.2 ± 2.4 IU/L) when compared to mild GO (3.2 ± 1.6 IU/L) ( P < 0.001). TRAb positivity was similar between groups. Braley's sign, i.e., the differential intraocular pressure (IOP) of >6 mmHg, was statistically significantly higher in severe GO ( P < 0.001). Male gender, current smoking, TRAb >2 upper limit of normal (ULN), and differential IOP >6 mmHg were found to be associated with severe GO. CONCLUSION: Approximately 35% of the patients with GO have severe disease, with a higher risk in men. This study identified male gender, current smoking, TRAb >2 ULN, and differential IOP >6 mmHg to be associated with severe GO.

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“…(18) Dalam studi Mathur et al, didapatkan bahwa rokok, jenis kelamin laki laki dan semakin tinggi CAS berkaitan dengan derajat keparahan GO. (19) Sementara itu, dalam sebuah analisa multivariat tang dilakukan Lat et al, didapatkan bahwa jenis kelamin laki-laki dan peningkatan TRAb (thyroid hormone receptor antibody) berkaitan dengan derajat keparahan GO, (masing-…”

Section: Epidemiologiunclassified

“…(1,2) Rokok merupakan faktor risiko yang berpotensi meningkatkan progresitivitas GO dan meningkatkan risiko GO berkembang menjadi lebih berat. (19) Pada pasien GD dengan GO sering kali pasien juga mengalami hipertiroid, sehingga sebaiknya juga dilakukan penanganan terhadap hipertiroid (jika ada), namun sebisa mungkin hindari hipotiroid iatrogenik. (1) Selain itu, pada pasien harus dilakukan identifikasi, apakah terdapat sindroma mata kering.…”

Section: Tatalaksanaunclassified

Unveiling Modern Strategies for Diagnosing and Treating Grave Orbitopathy

Ujianto,

Sari,

Rakhman

2024

JK-RISK

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Graves' Orbitopathy (GO), also known as thyroid eye disease or thyroid-associated orbitopathy is characterized by inflammation, ocular muscle hypertrophy, adipogenesis, and oedema (due to glycosaminoglycan accumulation). This condition leads to remodeling, tissue expansion, and/or fibrosis within the fibroadipose tissue or extraocular muscles of the orbit. GO manifests as an extrathyroidal aspect of autoimmune thyroid diseases in both Grave's disease (GD) and Hashimoto's thyroiditis. The pathophysiological foundation of GO entails the infiltration of B cells, T cells, and CD34+ fibroblasts in the orbit. B cells generate IGF (insulin-like growth factor), wherein IGF and TRab (Thyroid-Receptor antibodies) stimulate the IGF receptor complex and thyrotropin receptor (respectively) on the surface of CD34+ cells which triggers orbital tissue expansion, orbital protrusion, optic nerve compression, and eyeball displacement, resulting in exophthalmos. GO progress through an active phase (characterized by inflammation with visible manifestations), followed by a plateau phase (stabilization of GO manifestations), and a gradual resolution of distinctive residual signs and symptoms (inactive phase). This entire process spans between 18-24 months in untreated patients, where disease manifestations significantly depend on the phase during which the disease is identified. GO therapy is intended to shorten the active phase and supress its residual eye manifestations during the inactive phase. In general, GO therapy is categorized into general and disease severity-specific approaches. GO therapy often falls short of providing satisfactory results, prompting need of surgery to address lingering clinical manifestations. This review presents the latest insights into the pathogenesis and treatment of GO for better management and outcomes.

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Prevalence and risk factors of thyroid-associated ophthalmopathy among Indians

Cited by 3 publications

References 16 publications

Prevalence of Thyroid Eye Disease in Patients With Thyroid Dysfunction in a Tertiary Care Hospital of Central Nepal

Prevalence of Thyroid Eye Disease in Patients With Thyroid Dysfunction in a Tertiary Care Hospital of Central Nepal

Factors associated with severity of orbitopathy in patients with Graves' disease

Unveiling Modern Strategies for Diagnosing and Treating Grave Orbitopathy

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