J Korean Ophthalmol Soc.  2013 Aug;54(8):1149-1156.

The Clinical Characteristics of Thyroid Orbitopathy in Thyroid Dysfunction Pediatric Patients

• Bae JB
• Cheong HM
• Yoo JH
• Kwon YH
• Ahn HB

Abstract

PURPOSE
To investigate the clinical characteristics and treatment methods for pediatric thyroid-associated orbitopathy in pediatric patients with thyroid disorders.
METHODS
To determine the prevalence and clinical characteristics of pediatric thyroid-associated orbitopathy, we retrospectively analyzed the medical records of 34 patients admitted to the Pediatrics Department of our institution between September 2010 and September 2012. The patients had been diagnosed with autoimmune thyroid disorder and were admitted for treatment of thyroid-associated orbitopathy.
RESULTS
In the 24.1 months of follow-up observation, 14 patients were diagnosed with Graves' disease (41.2%) and 20 patients with Hashimoto's thyroiditis (58.8%). Of the 34 patients, 15 (44.1%) developed eye symptoms. Among the eye symptoms, lid swelling was the most prevalent in 41.2% of patients, followed by eyelid retraction in 23.5%, lid lag in 17.6%, conjunctival injection in 14.7%, proptosis in 8.8%, and extraocular muscle hypertrophy in 17.6%. Severe impairment of visual acuity, visual field, and ocular motility were not observed in our study. Although eyelid surgery was performed in 3 cases, most patients were treated conservatively.
CONCLUSIONS
Pediatric thyroid-associated orbitopathy was frequently observed in patients with Graves' disease and Hashimoto's thyroiditis. Compared to adults, children showed milder disease manifestation and progression, and the disease could be managed with conservative treatment.

Keyword

Graves' disease; Hashimoto's thyroiditis; Pediatric; Thyroid-associated orbitopathy

MeSH Terms

Adult
Child
Exophthalmos
Eye
Eyelids
Follow-Up Studies
Graves Disease
Humans
Hypertrophy
Medical Records
Muscles
Pediatrics
Prevalence
Retrospective Studies
Thyroid Gland
Thyroiditis
Visual Acuity
Visual Fields

Figure

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  Figure 1. Scatter plots depicting relationships between Free T4 and Proptosis measured by Hertel exophtalmometer. Continuous lines represent regression lines of relationships. (A) Free T4 vs separate value of right eyes (in mm) measured by Hertel exophtalmometer. (B) Free T4 vs separate value of left eyes (in mm) measured by Hertel exophtalmometer.

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