Clinical characteristics and the treatment modalities of Graves' orbitopathy in a tertiary referral center in Turkey: changes over two decades

Ozturk M., Konuk O., Tarlan B., Yalcin M. M., Aribas Y. K., Toruner F. S., ...Daha Fazla

INTERNATIONAL OPHTHALMOLOGY, cilt.43, sa.2, ss.643-653, 2023 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 43 Sayı: 2
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1007/s10792-022-02468-2
  • Dergi Adı: INTERNATIONAL OPHTHALMOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.643-653
  • Anahtar Kelimeler: Graves' orbitopathy, Ophthalmopathy, Graves' disease, Epidemiology, Thyroid, EUROPEAN GROUP, NATURAL-HISTORY, OPHTHALMOPATHY, DISEASE, MANAGEMENT, HYPERTHYROIDISM, EPIDEMIOLOGY, POPULATION, PREVALENCE, GUIDELINES
  • Gazi Üniversitesi Adresli: Evet

Özet

Purpose To evaluate the changes in demographics, clinical findings, and treatment modalities in Graves' orbitopathy (GO) patients at a tertiary referral center in Turkey over the last two decades. Methods The clinical data of 752 GO patients were evaluated retrospectively. Patients were divided into 2 groups according to the first ophthalmic examination date; Group 1(n:344) between January 1998 and December 2007 and Group 2(n:408) between January 2008 and December 2017. Results The number of nonsmokers was significantly higher in Group 2 (44.0 vs. 26.5%, p < 0.001). The time from the diagnosis of thyroid dysfunction and referral to our center was 32.4 months in Group 1 and 34.8 months in Group 2, (p = 0.166). The most common treatment of hyperthyroidism was antithyroid medications. Radioiodine ablation treatment rate was significantly lower in Group 2 (14.8 vs. 9.1%, p < 0.001). The time between the diagnosis of thyroid disease and orbital involvement was 22.0 vs. 26.6 months in Groups 1 and 2, respectively (p = 0.009). The time elapsed between the diagnosis of orbital disease and referral to our clinic was 21.0 months vs. 22.4 months in Group 1 and 2, respectively (p = 0.068). Orbital disease was most commonly mild, and inactive. Mild and moderate to severe GO and the mean Clinical Activity Score significantly increased, and the rate of sight-threatening disease and orbital decompression surgery significantly decreased in Group 2 (p = 0.042; p < 0.001, respectively). Conclusions Mild and inactive orbital disease was the most common form of GO. The severity of GO is declining over the last two decades in Turkey.