title: Factors associated with decompression and strabismus surgery in thyroid eye disease.
abstract: BACKGROUND
  Prognostication of the thyroid patient with eye disease aids in the choice of treatment strategy. To facilitate this, we investigated factors associated with decompression and/ or strabismus surgery in the Singaporean population.
  
  
  METHODS
  A 5-year retrospective study was performed. Patients who required strabismus and/or decompression surgery (n = 23) were compared to those who did not undergo either surgery (n = 44). Individual and multivariate age-adjusted odds ratios were calculated to determine significant associations.
  
  
  RESULTS
  Individually, male gender [odds ratio (OR), 4.5; 95% confidence interval (CI), 1.5 to 13.4], uncontrolled hyperthyroidism (OR, 4.0; 95% CI, 1.1 to 14.3), steroid therapy (OR, 7.4; 95% CI, 2.3 to 24), diplopia (OR, 7.3; 95% CI, 2.3 to 23.1), objective vertical myopathy (OR, 11.7; 95% CI, 1.4 to 96.0), elevated intraocular pressure in the primary position (OR, 3.4; 95% CI, 1.2 to 10.0) and clinical evidence of optic neuropathy (OR, 13.1; 95% CI, 1.4 to 124.6) were significantly associated with the need for surgery. Logistic regression analysis showed the greater impact of male gender (OR, 4.2; 95% CI, 1.2 to 15.4), optic neuropathy (OR, 13.0; 95% CI, 1.2 to 143.7) and previous steroid therapy (OR, 4.2; 95%CI, 1.1 to 16.2) on prognostication.
  
  
  CONCLUSIONS
  Chances of requiring strabismus and/or decompression surgery are significantly higher for male patients and those with uncontrolled hyperthyroidism. In particular, male patients with optic neuropathy and a history of previous steroid therapy warrant a graver prognosis.
authors.affiliation: Oculoplastic Service, Singapore National Eye Centre, Singapore. audrey_looi@yahoo.com.sg
authors.forename: A L G
authors.initials: AL
authors.lastname: Looi
authors.forename: C D
authors.initials: CD
authors.lastname: Luu
authors.forename: T Y
authors.initials: TY
authors.lastname: Wong
authors.forename: L L
authors.initials: LL
authors.lastname: Seah
authors.forename: J
authors.initials: J
authors.lastname: Rootman
mesh_terms: D000328:Adult; D019299:Decompression, Surgical; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013285:Strabismus / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*