J Korean Ophthalmol Soc.  2008 Sep;49(9):1387-1396.

The Clinical Characteristics of Thyroid Orbitopathy in Thyroid Dysfunction Patients in Korea

• Woo KI
• Kim YD
• Lee SY
• Korean Society of Ophthalmic Plastic and Reconstructive Surgery

Abstract

PURPOSE
To investigate the clinical manifestation of thyroid orbitopathy among patients with thyroid dysfunction.
METHODS
A cross-sectional study was conducted at 24 general hospitals in Korea. All dysthyroid patients who visited the endocrinology clinic for 1 week were included. Data were collected during an interviewer-administered questionnaire. Thyroid orbitopathy was diagnosed in cases with relevant symptoms according to the VISA classification for which an eye examination was performed. Three hundred seventy-one patients who had thyroid orbitopathy out of 1986 dysthyroid patients were evaluated.
RESULTS
Vision symptoms were presented in 10.5% of thyroid orbitopathy patients, inflammation symptoms in 43.1%, strabismus in 15.1%, and appearance and exposure symptoms in 86.3% of patients. Among the eye symptoms, proptosis was most prevalent in 56.9% of patients followed by eyelid retraction in 31.5%, diplopia in 15.1% and optic nerve dysfunction in 2.4% of patients. Median value of exophthalmometry in the thyroid orbitopathy group was 16 mm and 17 mm in the proptosis group. Patient self assessment for thyroid orbitopathy from the onset of the disease was "greatly improved" in 12.1% of patients, "improved" in 19.5%, "unchanged" in 51.2%, "worse" in 19.6%, and "much worse" in 1.0% of patients.
CONCLUSIONS
Among dysthyroid patients, significant amount was found to have symptoms related with thyroid orbitopathy. The patients with thyroid orbitopathy, except for the mildest cases, need to be managed by a thyroid eye disease specialist for further assessment and care.

Keyword

Clinical manifestations; Dysthyroid; Proptosis; Thyroid orbitopathy

MeSH Terms

Cross-Sectional Studies
Diplopia
Endocrinology
Exophthalmos
Eye
Eye Diseases
Eyelids
Hospitals, General
Humans
Inflammation
Korea
Optic Nerve
Surveys and Questionnaires
Self-Assessment
Specialization
Strabismus
Thyroid Gland
Vision, Ocular

Figure

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  Figure 1. Age and gender distribution of all dysthyroid patients.

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  Figure 2. Distribution of total exophthalmometric values of thyroid orbitopathy (586 eyes of 298 patients). It shows the number of eyes in each value of the patients without proptosis and with proptosis.

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  Figure 3. Distribution of the margin-reflex distance (MRD1) of the upper eyelids in thyroid orbitopathy patients. (558 eyes of 279 patients)

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  Figure 4. Distribution of the scleral show in the lower eyelids in 463 eyelids.

Reference

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