[Clinical analysis of 403 cases of thyroid associated ophthalmopathy].
OBJECTIVE
To monitor and summarize the clinical manifestation of thyroid associated ophthalmopathy (TAO) and to analyze the thyroid function and any other factors that may have effects on the progression of TAO.


METHODS
Retrospectively, 403 TAO cases (676 eyes) were collected from November 2009 to June 2012 and their clinical manifestations were summarized and analyzed (quantitative and qualitative data were analyzed by using chi-square test and t-test, respectively; the relationship between various factors and TAO was analyzed with logistic regression).


RESULTS
TAO occurred mostly in individuals over 40 years with no gender preference (χ(2) = 0.133, P = 0.715) and characteristically bilateral. In our study, abnormal thyroid function was present in 303 cases, in which hyperthyroidism was found in 289 cases. In 62 hyperthyroidism patients accepting I(131) treatment, 51 cases (82.26%) developed hypothyroidism and 64.71% of them developed TAO or showed progression of TAO. TAO with over 2 grade in severity (67.66%) and 4 grade in CAS (40.29%) occurred more frequently in patients with abnormal thyroid function than those with euthyroidism (37.00% vs. 21.32%). Edema of eyelids was the major manifestation and main reason for ophthalmic examination. Eye lids retraction and lagging eyelids were present in 75.93% and 83.37% cases, respectively. Involvement of extraocular muscle presented in 49.38% cases. Lagophthalmos and damage of the cornea appeared in 10.42% and 9.43% cases, respectively. CT examination showed that the most common involvement of extraocular muscles was inferior rectus; medial and superior rectus were the second and the third involved muscles, respectively. Lateral rectus was seldom involved. The VI and V grade of TAO occurred in 67.47% of 56 cases with smoking habit.


CONCLUSIONS
Thyroid function has a certain relationship to the severity of TAO. Hypothyroidism after the I(131) may be related to the progression of TAO. Smoking may also correlated with the severity of TAO.
Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, China.
Yu-jiao
YJ
Wang
Wei-min
WM
He
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D049970:Graves Ophthalmopathy / Q000503:physiopathology*; D006801:Humans; D007037:Hypothyroidism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D055815:Young Adult