Clinical phenotypes of euthyroid, hyperthyroid, and hypothyroid thyroid-associated ophthalmopathy

Area of Science:

• Ophthalmology
• Endocrinology
• Thyroid Disease Research

Background:

• Thyroid-associated ophthalmopathy (TAO) is an autoimmune condition affecting the eye, often associated with Graves' disease.
• TAO's clinical presentation and progression can vary, potentially influenced by the patient's thyroid status (euthyroid, hyperthyroid, or hypothyroid).

Purpose of the Study:

• To compare the demographic and clinical characteristics of thyroid-associated ophthalmopathy (TAO) in patients with euthyroidism (Eu-TAO), hyperthyroidism (Hr-TAO), and hypothyroidism (Ho-TAO).

Main Methods:

• A retrospective analysis of 2158 thyroid-associated ophthalmopathy patients.
• Assessment of patient demographics, clinical manifestations, disease activity, and severity based on thyroid status.

Main Results:

• Euthyroid TAO (Eu-TAO) patients (24.37%) were older and had a lower female-to-male ratio compared to hyperthyroid (Hr-TAO) and hypothyroid (Ho-TAO) groups.
• Eu-TAO patients exhibited a higher prevalence of unilateral eye involvement (50%) and milder disease severity (67.68% mild) than Hr-TAO or Ho-TAO patients.
• Clinical activity was observed in 8.56% of Eu-TAO, 13.86% of Hr-TAO, and 11.36% of Ho-TAO patients.

Conclusions:

• Euthyroid TAO patients are typically older, less frequently female, and present with more unilateral and milder clinical phenotypes compared to those with hyperthyroid or hypothyroid TAO.
• These findings highlight distinct clinical profiles of TAO based on thyroid function, aiding in tailored patient management.