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

  • Inflammatory Disorders
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Abstract

Objective

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

Methods

We enrolled 2158 TAO patients in this retrospective study and assessed their demographics, clinical manifestations, activity, and severity.

Results

Among the enrolled patients, 526 (24.37%) had Eu-TAO, 1544 (71.55%) had Hr-TAO, and 88 (4.08%) had Ho-TAO. Compared to Hr-TAO (2.02) and Ho-TAO (2.52) patients, Eu-TAO (1.57) patients had the lowest female-to-male ratio (p = 0.026). The mean ages of Eu-TAO, Hr-TAO, and Ho-TAO patients were 43.11 ± 12.05, 42.23 ± 13.63, and 47.39 ± 13.28 years, respectively (p = 0.001). Patients with Eu-TAO had more unilateral involvement (50% vs. 14.38% vs. 21.59%, p < 0.001) than Hr-TAO or Ho-TAO patients. Clinically active TAO patients presented 8.56% in euthyroid vs. 13.86% in hyperthyroid vs. 11.36% in hypothyroid (p = 0.006). Regarding the severity of the European Group on Graves’ Orbitopathy (EUGOGO) classification among euthyroid, hyperthyroid, and hypothyroid patients, mild TAO was present in 67.68, 54.27, and 72.72% of participants, moderate-to-severe TAO in 31.18, 42.49, and 26.14%, and sight-threatening TAO in 1.14, 3.24, and 1.14%, respectively. Eu-TAO was positively correlated with unilateral involvement (OR = 5.671, p < 0.001) and age (OR = 1.013, p = 0.003) and negatively correlated with the female-to-male ratio (OR = 0.656, p < 0.001) and TAO severity (OR = 0.742, p < 0.01).

Conclusions

Eu-TAO patients are older and less likely to be female, and show more unilateral and milder clinical phenotypes than hyper/hypothyroid TAO patients.

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Funding

This work was supported by West China Hospital, Sichuan University (grant number 2018HXFH024); and Sichuan Provincial Science and Technology Program (grant number 18ZDYF1977).

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Authors and Affiliations

  1. Department of Ophthalmology, West China School of Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Wuhou District, Chengdu, 610041, Sichuan Province, China

    Mei Yang, Yujiao Wang, Baixue Du & Weimin He

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  1. Mei Yang
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  2. Yujiao Wang
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  3. Baixue Du
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Contributions

Mei Yang: conception, design, data collection, literature search, and preparation and editing of the manuscript. Baixue Du: collection and interpretation of data. Yujiao Wang and Weimin He: critically revising the manuscript for important intellectual content. All authors reviewed and approved the manuscript.

Corresponding author

Correspondence to Weimin He.

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All procedures performed in this study involving human participants were in accordance with and approved by the review board of West China Hospital of Sichuan University and conformed to the Declaration of Helsinki.

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Yang, M., Wang, Y., Du, B. et al. Clinical phenotypes of euthyroid, hyperthyroid, and hypothyroid thyroid-associated ophthalmopathy. Graefes Arch Clin Exp Ophthalmol 261, 1995–2002 (2023). https://doi.org/10.1007/s00417-023-05998-2

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