Guy J Ben Simon1,2, Gabriel Katz3,4, Ofira Zloto3,4, Hana Leiba5,6, Beatrix Hadas5,6, Ruth Huna-Baron3,4. 1. Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel. guybensimon@gmail.com. 2. The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel. guybensimon@gmail.com. 3. Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel. 4. The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel. 5. Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel. 6. The Hebrew University Faculty of Medicine, Jerusalem, Israel.
Abstract
PURPOSE: To examine the clinical differences in manifestation, course, treatment, and prognosis of thyroid eye disease (TED) in patients younger than 40 years of age at diagnosis compared to older patients. METHODS: Medical record review of 131 TED patients was performed. The patients were divided into two age groups, Group 1 ≤ 40 years (23 patients) and Group 2 > 40 years (108 patients). RESULTS: Younger patients had more eyelid retraction and proptosis at initial presentation, whereas older patients were more likely to have diplopia (P = 0.001). Acute inflammatory signs were more common in the Group 2 patients (P = 0.04). Corrected visual acuity was 20/20 and 20/25 in both groups. Optic neuropathy was diagnosed only in Group 2 patients (n = 12; 11 %), and it resolved after steroids or orbital decompression surgery in all cases. The mean follow-up time was 36 months (36 ± 7.7; 59.3 ± 5.8). Systemic steroid use, orbital surgery, and strabismus surgery were more common in Group 2 (P < 0.0001, P < 0.05 respectively). CONCLUSIONS: TED under the age of 40 years has different clinical features. In our group of younger patients, the clinical presentation was milder than in the older group with a higher rate of lid retraction and proptosis and lower rate of restrictive myopathy and optic neuropathy. Their disease course was less severe and required less aggressive medical treatment and less surgical procedures.
PURPOSE: To examine the clinical differences in manifestation, course, treatment, and prognosis of thyroid eye disease (TED) in patients younger than 40 years of age at diagnosis compared to older patients. METHODS: Medical record review of 131 TED patients was performed. The patients were divided into two age groups, Group 1 ≤ 40 years (23 patients) and Group 2 > 40 years (108 patients). RESULTS: Younger patients had more eyelid retraction and proptosis at initial presentation, whereas older patients were more likely to have diplopia (P = 0.001). Acute inflammatory signs were more common in the Group 2 patients (P = 0.04). Corrected visual acuity was 20/20 and 20/25 in both groups. Optic neuropathy was diagnosed only in Group 2 patients (n = 12; 11 %), and it resolved after steroids or orbital decompression surgery in all cases. The mean follow-up time was 36 months (36 ± 7.7; 59.3 ± 5.8). Systemic steroid use, orbital surgery, and strabismus surgery were more common in Group 2 (P < 0.0001, P < 0.05 respectively). CONCLUSIONS: TED under the age of 40 years has different clinical features. In our group of younger patients, the clinical presentation was milder than in the older group with a higher rate of lid retraction and proptosis and lower rate of restrictive myopathy and optic neuropathy. Their disease course was less severe and required less aggressive medical treatment and less surgical procedures.
Authors: David McKeag; Carol Lane; John H Lazarus; Lelio Baldeschi; Kostas Boboridis; A Jane Dickinson; A Iain Hullo; George Kahaly; Gerry Krassas; Claudio Marcocci; Michele Marinò; Maarten P Mourits; Marco Nardi; Christopher Neoh; Jacques Orgiazzi; Petros Perros; Aldo Pinchera; Susanne Pitz; Mark F Prummel; Maria S Sartini; Wilmar M Wiersinga Journal: Br J Ophthalmol Date: 2006-10-11 Impact factor: 4.638
Authors: C Marcocci; L Bartalena; M L Tanda; L Manetti; E Dell'Unto; R Rocchi; G Barbesino; B Mazzi; M P Bartolomei; P Lepri; F Cartei; M Nardi; A Pinchera Journal: J Clin Endocrinol Metab Date: 2001-08 Impact factor: 5.958
Authors: A Allahabadia; J Daykin; R L Holder; M C Sheppard; S C Gough; J A Franklyn Journal: J Clin Endocrinol Metab Date: 2000-03 Impact factor: 5.958
Authors: Shueh Lin Lim; Andrew Keat Eu Lim; Malik Mumtaz; Elias Hussein; Wan Mohamad Wan Bebakar; Amir S Khir Journal: Thyroid Date: 2008-12 Impact factor: 6.568