title: Chronology of Graves' ophthalmopathy in an incidence cohort.
abstract: OBJECTIVE
  To determine the chronologic characteristics of Graves' ophthalmopathy in an incidence cohort of 120 patients.
  
  
  METHODS
  We reviewed the community medical records of 120 patients residing in Olmsted County, Minnesota, in whom Graves' ophthalmopathy had been diagnosed between 1976 and 1990.
  
  
  RESULTS
  Median age at the time of diagnosis of Graves' ophthalmopathy was 43 years; the minimum and maximum ages were 8 and 88 years, respectively. Among 108 patients with hyperthyroidism, ophthalmopathy was diagnosed in the six-month interval preceding the diagnosis of thyroid dysfunction in 20 patients (18.5%); ophthalmopathy was concurrent with the diagnosis of hyperthyroidism in 22 patients (20.3%); and ophthalmopathy developed in the six-month interval after thyroid diagnosis in 24 patients (22.2%). Ophthalmopathy was diagnosed more than six months before the diagnosis of hyperthyroidism in only four additional patients (3.7%), whereas ocular changes developed six months or more after thyroid disease in the remaining 38 patients (35.2%). There was no significant seasonal variation in the diagnosis of either thyroid dysfunction or ophthalmopathy. Treatment of hyperthyroidism with iodine-131 did not appear to influence the course of Graves' ophthalmopathy.
  
  
  CONCLUSIONS
  There is a strong temporal relationship between the thyroid and eye manifestations of Graves' disease. The diagnosis of Graves' ophthalmopathy tends to follow the diagnosis of hyperthyroidism. Treatment with iodine-131 does not appear to influence the course of Graves' ophthalmopathy. Although both childhood Graves' disease and Graves' ophthalmopathy are uncommon, ophthalmopathy occurs at all ages.
authors.affiliation: Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
authors.forename: G B
authors.initials: GB
authors.lastname: Bartley
authors.forename: V
authors.initials: V
authors.lastname: Fatourechi
authors.forename: E F
authors.initials: EF
authors.lastname: Kadrmas
authors.forename: S J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: D M
authors.initials: DM
authors.lastname: Ilstrup
authors.forename: J A
authors.initials: JA
authors.lastname: Garrity
authors.forename: C A
authors.initials: CA
authors.lastname: Gorman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D013956:Antithyroid Agents / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D005128:Eye Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006111:Graves Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D015994:Incidence; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D013961:Thyroid Gland / Q000528:radiation effects; D013965:Thyroidectomy
chemical_list: D013956:Antithyroid Agents; D007457:Iodine Radioisotopes