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How Age Affects Graves' Orbitopathy-A Tertiary Center Study.

Michael Oeverhaus1, Julius Sander1, Nicolai Smetana1

  • 1Department of Ophthalmology, University Hospital Essen, 45147 Essen, Germany.

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|January 11, 2024
PubMed
Summary

Younger Graves' orbitopathy (GO) patients typically have milder disease, while older patients experience more severe symptoms and require more interventions. Age influences treatment needs but not significantly the risk of dysthyroid optic neuropathy (DON).

Keywords:
GOGraves’ orbitopathyTEDagereoperationstrabismusthyroid eye disease

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Area of Science:

  • Ophthalmology
  • Endocrinology
  • Autoimmune Diseases

Background:

  • Graves' orbitopathy (GO) is an autoimmune condition causing inflammation, adipogenesis, and fibrosis in orbital tissues.
  • Disease severity varies, complicating accurate prognosis and personalized treatment strategies.

Purpose of the Study:

  • To compare clinical characteristics, disease course, treatment, and prognosis between GO patients under 50 years and those over 50.

Main Methods:

  • Retrospective analysis of 1000 patients from the GO database Essen (GODE).
  • Patients were categorized into two groups: Group 1 (≤50 years) and Group 2 (>50 years).
  • Statistical analysis included comparison of clinical features, severity scores, and treatment outcomes.

Main Results:

  • Younger patients (n=484) predominantly presented with mild GO (53% vs. 33%), whereas older patients (n=448) more frequently had moderate-to-severe disease (64% vs. 44%).
  • Older patients exhibited more severe strabismus and motility issues (p < 0.0001) and higher clinical activity scores (p = 0.001).
  • Need for secondary eye muscle surgery was associated with prior decompression, orbital irradiation, and age (AUC = 0.83).

Conclusions:

  • Younger GO patients present with milder clinical features, including fewer restrictive motility disorders and less inflammation.
  • Older patients generally require more intensive treatments such as steroids, irradiation, and surgical interventions.
  • Age shows minimal association with the risk of dysthyroid optic neuropathy (DON) and secondary eye muscle surgery.