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Severe Pediatric Thyroid Eye Disease: Surgical Case Series.

Chris Y Wu1, Victor M Elner, Alon Kahana

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Summary

Severe thyroid eye disease (TED) can affect children, necessitating orbital decompression for vision-threatening complications like optic neuropathy and proptosis. This study highlights rare pediatric cases, emphasizing the need for further research into TED disparities.

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Area of Science:

  • Ophthalmology
  • Endocrinology
  • Pediatrics

Background:

  • Thyroid eye disease (TED) typically presents with mild symptoms in pediatric patients.
  • Orbital decompression surgery is rarely required in children with TED.

Observation:

  • This study details three pediatric cases (ages 16 or younger) with severe orbitopathy requiring orbital decompression.
  • Cases included compressive optic neuropathy, stretch optic neuropathy, globe subluxation, and severe proptosis.
  • Patients presented with Graves' disease or unilateral euthyroid TED.

Findings:

  • All three pediatric patients underwent successful orbital decompression surgery.
  • Surgical interventions effectively addressed vision-threatening conditions, including optic neuropathy and proptosis.
  • This marks the first reported instances of thyroid-related optic neuropathy and globe subluxation in pediatric patients.

Implications:

  • Children, regardless of pubertal status, can develop severe, visually threatening orbitopathy from TED.
  • These findings underscore the potential for severe TED manifestations in pediatric populations.
  • Further research is needed to understand the mechanisms behind differences in pediatric versus adult TED.