Liya K.Y.1, Naina Jabeen Hyder2, Neeta Sidhan3, Shaji Ankan4
BACKGROUND
Thyroid eye disease is a relatively rare condition, with an incidence of 2.9 to 16.0
cases per 100 000 population per year. Approximately 50 % of patients with
Graves’ disease (GD) develop clinically apparent thyroid eye disease. It may cause
severe damage to vision and orbital architecture. It is the most frequent cause of
unilateral or bilateral proptosis in adults.
METHODS
A cross sectional study of 80 patients with GD was carried out in association with
thyroid clinic of Government Medical college Thiruvananthapuram for a period of
1 year from April 2017 to March 2018. Subjects who have a prior diagnosis of
Graves’ disease including those who are on antithyroid drugs were included in the
study. Patients who are sick due to other systemic diseases like cardiac failure and
end stage renal disease were excluded.
RESULTS
Eighty patients with mean age of 45.31 years were studied. Out of them, 66%
were females and 34% were males. Ophthalmopathy was present in
38.8%.Majority had mild and bilateral disease (61.2 %). Only a small percentage
had sight threatening disease (6.4 %).The mean age of patients with
ophthalmopathy was 47.93. Major population with ophthalmopathy was females.
Majority of patients with ophthalmopathy (64.5 %) retained a good visual acuity
better than 6 / 9. Lid retraction was the most common manifestation among
patients with Graves’ ophthalmopathy that is 74.2% followed by exophthalmos
(64.5 %) and eye movement restriction and soft tissue involvement (58.1 %).
Diplopia, optic nerve dysfunction were rare (3.2 %). Only 19.3 % patients had
active disease according to clinical activity score. Major clinical sign of activity was
redness of conjunctiva. Maximum no. of patients with active disease had a clinical
activity score of 4. Smoking showed a significant association with the severity of
ophthalmopathy. (p value 0.001) There was a significant association between age
and activity of disease. (p value 0.021). No association was found between
duration of disease with presence or severity of ophthalmopathy. There was no
association between co- morbidities with presence or severity of ophthalmopathy.
No association was found between hormone status and presence or severity of
ophthalmopathy.
CONCLUSIONS
Our results indicated that the prevalence of ophthalmopathy in our population with
GD evaluated at our tertiary care centre was similar to that reported in the
Caucasians of European origin. Clinically active and sight threatening
ophthalmopathy was uncommon.
