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[Thyroid-associated ophthalmopathy: a clinical study of 381 cases]
1Shanghai Clinical Center for Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
Objective:
To find the clue of making accurate diagnosis for thyroid-associated ophthalmopathy (TAO) by analyzing 381 cases.
Methods:
We analyzed 381 cases with TAO diagnosed in Ruijing Hospital to summarize the characteristics of clinical symptoms and signs, the type and duration of thyroid disorders, the image study of computerized tomography and to know the effect of some influencing factors on the course and severity of TAO.
Results:
(1) In the 381 cases of TAO, only 86.4% had hyperthyroidism, as TAO could be associated with hypothyroidism or euthyroidism. Ophthalmopathy occurred simultaneously with the development of hyperthyroidism or followed it 18.8 months later in the majority of the patients. (2) Upper eyelid retraction was the commonest sign of the lids. 120 cases complained of double vision. 89 had eye movement restriction, especially to upper direction. Mean extent of proptosis was 17.9 mm. 14.5% had high intraocular pressure. The extraocular muscles involvement was characteristically bilateral and multiple. The inferior rectus was the most frequently involved with enlargement. (3) Only 19.2% cases received corticosteroids, retrobulbar irradiation or surgery because of the severity of ocular symptoms and signs.
Conclusions:
TAO way occur with the development of hyperthyroidism simultaneously or follow it later. The disease has its own clinical characteristics and natural course. Making accurate diagnosis earlier is essential for instituting treatment and predicting prognosis.