title: [Thyroid ophthalmopathy: clinical activity determination of thyroid ophthalmopathy as a prognostic factor of immunosuppressive treatment response].
abstract: OBJECTIVE
  To determine the usefulness of the clinical, biochemical and thyroid imaging parameters in patients with thyroid-associated ophthalmopathy, in predicting their response to immunosuppressive treatment.
  
  
  METHODS
  This retrospective study of 16 patients with thyroid ophthalmopathy considered a number of variables including sex, age, thyroid hormone levels, treatment of the thyroid dysfunction, clinical activity score (CAS), severity (NOSPECS) of the ophthalmopathy, signs in standardized A-mode ultrasonography, in CAT and/or NMR, and previously used treatments and their effectiveness.
  
  
  RESULTS
  The average age of the patients was 50.81 (S.D: 11.89) years; there were 5 males (31.3%) and 11 females (68.8%). The ophthalmopathy was classified as active in 10/16 patients (62.5%) and inactive in 6/16 (37.5%); and as moderate in 9/16 (56.25%) and severe in 7/16 (43.75%) according to the severity defined in NOSPECS. Ultrasonography was diagnostic in 100% of the cases. The severity decreased significantly (p < or =0.05), however the clinical activity decrease did not reach significance (p=0.38) during immunosuppressive therapy. Better results were obtained during treatment of patients with a higher CAS (p=0.04) and in those with more severe ophthalmopathy (p=0.02). There was a tendency for the patients with higher levels of TSI to respond better to the treatment (p=0.06).
  
  
  CONCLUSIONS
  The CAS is the best parameter to quantify the activity of the disease and predicting the response to treatment. The higher the CAS and the more severe the ophthalmopathy, the better the response to treatment. No association existed between thyroid function and the activity or severity of the ophthalmopathy; or the effectiveness of treatment.
authors.affiliation: Servicio de Oftalmología, Clínica Universitaria de Navarra, Pamplona, Spain. abelzunce@medena.es
authors.forename: A
authors.initials: A
authors.lastname: Belzunce-Manterola
authors.forename: P J
authors.initials: PJ
authors.lastname: García-Gómez
authors.forename: M
authors.initials: M
authors.lastname: Casellas-Bravo
authors.forename: H
authors.initials: H
authors.lastname: Heras-Mulero
authors.forename: J
authors.initials: J
authors.lastname: Moreno-Montañés
mesh_terms: D000328:Adult; D000368:Aged; D013956:Antithyroid Agents / Q000627:therapeutic use; D005260:Female; D049970:Graves Ophthalmopathy / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013960:Thyroid Function Tests; D016896:Treatment Outcome
chemical_list: D013956:Antithyroid Agents; D007166:Immunosuppressive Agents