A study on the clinical profile of patients with thyroid-related orbitopathy presenting to a tertiary eye care institute

Sakshi Jain, Ayushi Gupta, Rakesh Porwal
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Abstract

Thyroid-associated orbitopathy is an autoimmune disorder that is the most frequent extrathyroidal involvement of Graves’ disease but sometimes occurs in euthyroid or hypothyroid patients. Patients with Thyroid associated disease present with chemosis, superior limbic keratoconjunctivitis, proptosis, lid retraction and oedema, restricted extraocular muscle, and dysthyroid optic neuropathy. This study was an observational cross-sectional study which included all the patients with all age groups who attended the Outpatient Department of a Tertiary Care Hospital, Ajmer, with signs and symptoms of thyroid-associated orbitopathy or diagnosed with thyroid-associated orbitopathy with no history of multiple endocrine disorder. 95 subjects satisfying the inclusion and exclusion criteria were enrolled in the study.The mean age of study participants was 43.93± 12.25 years. Age ranges from 21 years to 80 years. 59 (62.1%) were female. Among all patients 69 (72.6%) were hyperthyroid, 19 (20.0%) were euthyroid and 7 (7.4%) were euthyroid. 5 (5.2%) presented with dysthyroid optic neuropathy. 40(42.10%) cases were of active thyroid eye disease (TED) and the remaining 55 (57.8%) were inactive cases. Out of all active presenters, 30% were having Clinical Active Scoring (CAS) ≥4.Middleage group and female sex were the common clinical profile of the patients of TED. When active and Inactive TED groups were compared, findings such as Average CAS, dysthyroid optic neuropathy, average Hertel’s value, and presenting signs were significantly higher in the active group.
关于在一家三级眼科医疗机构就诊的甲状腺相关眼眶病变患者临床特征的研究
甲状腺相关性眶病是一种自身免疫性疾病,是巴塞杜氏病最常见的甲状腺外受累,但有时也会发生在甲状腺功能亢进或甲状腺功能减退的患者身上。甲状腺相关疾病患者表现为化脓、上肢角结膜炎、突眼、睑内缩和水肿、眼外肌受限以及甲状腺功能减退性视神经病变。本研究是一项观察性横断面研究,研究对象包括在阿杰梅尔一家三级甲等医院门诊部就诊的所有年龄组患者,这些患者均有甲状腺相关性眼眶病的症状和体征,或被诊断为甲状腺相关性眼眶病,但没有多种内分泌疾病的病史。95名符合纳入和排除标准的受试者被纳入研究。研究对象的平均年龄为(43.93±12.25)岁,年龄范围在 21 岁至 80 岁之间。59人(62.1%)为女性。所有患者中有 69 人(72.6%)甲状腺功能亢进,19 人(20.0%)甲状腺功能减退,7 人(7.4%)甲状腺功能正常。5人(5.2%)患有甲状腺功能减退性视神经病变。40例(42.10%)为活动性甲状腺眼病(TED),其余55例(57.8%)为非活动性病例。在所有活动性TED患者中,30%的患者临床活动评分(CAS)≥4.中年组和女性是TED患者常见的临床特征。比较活跃组和非活跃 TED 组,发现活跃组的平均 CAS 值、甲状腺机能减退性视神经病变、平均 Hertel 值和表现体征明显高于非活跃组。
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