Evaluation of the Prevalence and Activity of Thyroid Ophthalmopathy in Patients with Thyroid Disease (Graves' Disease) Tiroid Hastalarında (Graves Hastalığı) Tiroid Oftalmopati Sıklığı ve Aktivitesinin Değerlendirilmesi
Medical Journal of Bakirkoy, cilt.21, sa.4, ss.398-404, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 21 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.4274/bmj.galenos.2025.2025.7-11
- Dergi Adı: Medical Journal of Bakirkoy
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.398-404
- Anahtar Kelimeler: Graves' disease, thyroid associated ophthalmopathy, clinical activity score
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: To evaluate the prevalence, activity status, and clinical spectrum of thyroid associated ophthalmopathy (TAO) in patients with Graves’ disease (GD), and to investigate the incidence of TAO activation and treatment approaches employed during follow-up. Methods: This retrospective observational cohort study included 371 patients with GD who were referred from the endocrinology clinic to an the ophthalmology department and followed for at least 6 months. Thyroid function status at presentation (euthyroid, hypothyroid, or hyperthyroid), treatments for GD, thyroid-stimulating hormone receptor antibody (TRAb) levels, systemic comorbidities (diabetes mellitus, hypertension), and smoking status were recorded. Ocular involvement was evaluated using the clinical activity score (CAS), with CAS ≥3 indicating active TAO. Results: Active TAO developed in 17.5% of GD patients. While most of these patients were in the hyperthyroid phase, a considerable proportion were in the euthyroid or hypothyroid phases. Patients with active TAO exhibited higher TRAb levels. Smoking emerged as a significant risk factor for TAO development. The most commonly administered treatment was intravenous methylprednisolone, followed by thyroidectomy, orbital radiotherapy, radioactive iodine therapy, and orbital decompression surgery. Conclusion: Patients with GD, there is a risk of developing TAO during follow-up, even in those asymptomatic at presentation. Regular ophthalmologic assessment is recommended, particularly for patients who smoke or have elevated TRAb levels. CAS remains a valuable tool for evaluating disease activity and guiding treatment decisions.