Demography, clinical presentation and management of thyroid orbitopathy: A prospective interventional cohort study at a regional institute of ophthalmology in Western India

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Original Article

Author Details : Garima Agrawal*

Volume : 5, Issue : 4, Year : 2019

Article Page : 157-165

https://doi.org/10.18231/j.ijooo.2019.041

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Abstract

Introduction: Thyroid orbitopathy or Graves’ orbitopathy has been known since almost two centuries
with the ocular changes associated with thyroid disease being first published by Graves in 1835. Thyroid
orbitopathy is an autoimmune disorder. It is a life -long disease with systemic and ocular manifestations.
Early diagnosis and appropriate management of this disorder are essential. The European group on graves
orbitopathy has put forward new updated guidelines for the management of this disorder. We designed a
study to document the demographics, clinical presentation and management of Thyroid orbitopathy patients
at our institute as per the new guidelines.
Aim: The current study aims to showcase the demography, clinical presentation and management of thyroid
orbitopathy at a centre of excellence in western India.
Materials and Methods: The study design was a prospective interventional study in an institutional
cohort. The study was carried out over a period two years from August 2017 to October 2019. Thirty
five consecutive cases of Thyroid orbitopathy presenting to the oculoplastics and ocular oncology clinic of
our western regional institute of ophthalmology were studied. They were subjected to a thorough history
taking, clinical examination. The thyroid ophthalmopathy was classified as mild, moderate to severe, sight
threatening. Active or inactive orbitopathy was documented. The patients were managed as per the recent
upadated globally accepted guidelines for the management of thyroid orbitopathy.
Observation and Results: Thyroid associated opthalmopathy was found in all age groups. The age range
was twelve years to seventy years. The maximum incidence was seen in the age group of thirty five
to fifty five years (68.57%). It was more common in females (female: male ratio was 4:3). The most
common clinical presentation was eyelid retraction(91.43%)followed by exophthalmos (77.14%). The
patients had the whole spectra of the ophthalmopathy from mild (65.72%) ,moderate-to-severe (25.71%) to
sight threatening ophthalmopathy (8.57%)though the latter cases were few. The disease activity was both
active (31.43%) a n d quiescent (68.57%) with the latter dominating the scenario. The patients had the risk
factors of active and passive smoke (45.71%) as well as thyroid dysfunction (97.14%). The patients were
successfully managed as per the recent proposed updated guidelines of management of the disorder both
medically as well as surgically.
Conclusion: The study adds the demographic and clinical profile of thyroid orbitopathy patients seen at a
centre of excellence, tertiary care centre in western India. The disease has been studied from our unique
perspective and managed as per the globally accepted current guidelines.

Keywords: Thyroid Orbitopathy, Demographics, Clinical presentation, Management, Western India.

How to cite : Agrawal G, Demography, clinical presentation and management of thyroid orbitopathy: A prospective interventional cohort study at a regional institute of ophthalmology in Western India. IP Int J Ocul Oncol Oculoplasty 2019;5(4):157-165

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