Hyperthyroid vs hypothyroid eye disease: the same severity and activity

• Published in: Eye (London) Vol. 25; no. 11; pp. 1442 - 1446
• Main Authors: Kashkouli, M B, Pakdel, F, Kiavash, V, Heidari, I, Heirati, A, Jam, S
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.11.2011; Nature Publishing Group
• Subjects: 692/699/2743/1841; Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Child; Clinical Study; Cross-Sectional Studies; Endocrinopathies; Female; Graves Ophthalmopathy - physiopathology; Humans; Hyperthyroidism - physiopathology; Hypothyroidism - physiopathology; Laboratory Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Miscellaneous; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Ophthalmology; Orbit diseases; Pharmaceutical Sciences/Technology; Severity of Illness Index; Surgery; Surgical Oncology; Thyroid. Thyroid axis (diseases); Young Adult; thyroid eye disease; hyperthyroidism; Graves' ophthalmopathy; hypothyroidism; orbitopathy; Endocrinopathy; Immunopathology; Orbit (eye) disease; Hyperthyroidism; Thyroid diseases; Autoimmune disease; Activity; Hypothyroidism; Eye disease; Exophthalmus; Graves disease; Ophthalmology; Comparative study
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2011.186

Purpose To compare demographics, severity, and activity of thyroid eye disease (TED) in patients with hyperthyroidism (Hr-TED) vs primary hypothyroidism (Ho-TED). Patients and Methods In a cross-sectional study, demographics, complete eye examination, severity score (NOSPECS, total hundred eye score), clinical activity score, and Rundle grading were recorded for patients with TED and different thyroid disorders referred from an endocrinology clinic from 2003 to 2006. Results TED was clinically found in 303 patients (303/851, 35.6%). The majority of them (280/303, 92.4%) had Graves' hyperthyroidism and 23 (23/303, 7.5%) had primary hypothyroidism. Mean age, gender, mean severity score, mean activity score, Rundle grade, unilateral presentation of TED, smoking habit, mean duration of eye disease, and mean interval time of thyroid to TED were not significantly different between the two groups (0.06< P <0.9). Mean duration of thyroid disease was significantly ( P =0.02) longer in the Hr-TED group (49.6 months) than in the Ho-TED group (22.7 months). Most of the patients in both groups (63.2% of Hr-TED and 73.9% of Ho-TED) developed the eye disease within 18 months before or after the thyroid disease. Conclusion The same demographics, clinical characteristics, and severity and activity scores for Hr-TED and Ho-TED imply that both groups present the same category of eye disease.