title: Change in quality of life after medical and surgical treatment of graves' ophthalmopathy.
abstract: OBJECTIVE
  To assess the changes in quality of life (QOL) of patients after treatment of their Graves' ophthalmopathy (GO).
  
  
  METHODS
  In this prospective, cross-sectional study, the GO-QOL questionnaire was completed by 67 subjects before and at least 6 months after steroid treatment (61 subjects, group 1) or optic neuropathy orbital decompression (6 subjects, group 2). Visual, psychosocial, education and counseling scores (higher score = better health), GO severity and clinical activity scores and minimal clinically important difference (MCID) were recorded and analyzed for correlation and statistical significance. A P-value <0.05 was considered statistically significant.
  
  
  RESULTS
  The mean age of patient enrolled in the study was 38.3 years, with 43 females (64.2%). The mean duration of thyroid dysfunction and GO were 40.1 and 26.5 months, respectively. Two treatment groups were similar for all the variables (0.06 < P < 0.9), except for higher mean age in the orbital decompression group (45.2 versus 37.7 years) (P = 0.03). Mean severity, activity, visual function and psychosocial function scores significantly improved in group 1 (steroid group) (P < 0.05, all cases). A significant improvement in clinical activity score and psychosocial scores occurred in group 2 (decompression group) (P < 0.05). MCID was achieved in two-thirds of the patients, with no significant difference between groups (P > 0.05). There was no significant effect of duration of thyroid disease and GO and severity and activity of GO on QOL scores either before or after treatment (P > 0.05, all cases).
  
  
  CONCLUSIONS
  Steroid treatment and orbital decompression significantly improve the QOL in GO. Duration, severity and activity of GO did not have a significant impact on the QOL.
authors.affiliation: Department of Eye, Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohsen Bahmani
authors.initials: MB
authors.lastname: Kashkouli
authors.forename: Iraj
authors.initials: I
authors.lastname: Heidari
authors.forename: Farzad
authors.initials: F
authors.lastname: Pakdel
authors.forename: Sara
authors.initials: S
authors.lastname: Jam
authors.forename: Yasamin
authors.initials: Y
authors.lastname: Honarbakhsh
authors.forename: Bahareh
authors.initials: B
authors.lastname: Mirarmandehi