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Age differences in clinical manifestation and prognosis of thyroid eye disease

  • Oculoplastics and Orbit
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To examine the clinical differences in manifestation, course, treatment, and prognosis of thyroid eye disease (TED) in patients younger than 40 years of age at diagnosis compared to older patients.

Methods

Medical record review of 131 TED patients was performed. The patients were divided into two age groups, Group 1 ≤ 40 years (23 patients) and Group 2 > 40 years (108 patients).

Results

Younger patients had more eyelid retraction and proptosis at initial presentation, whereas older patients were more likely to have diplopia (P = 0.001). Acute inflammatory signs were more common in the Group 2 patients (P = 0.04). Corrected visual acuity was 20/20 and 20/25 in both groups. Optic neuropathy was diagnosed only in Group 2 patients (n = 12; 11 %), and it resolved after steroids or orbital decompression surgery in all cases. The mean follow-up time was 36 months (36 ± 7.7; 59.3 ± 5.8). Systemic steroid use, orbital surgery, and strabismus surgery were more common in Group 2 (P < 0.0001, P < 0.05 respectively).

Conclusions

TED under the age of 40 years has different clinical features. In our group of younger patients, the clinical presentation was milder than in the older group with a higher rate of lid retraction and proptosis and lower rate of restrictive myopathy and optic neuropathy. Their disease course was less severe and required less aggressive medical treatment and less surgical procedures.

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Acknowledgments

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel

    Guy J. Ben Simon, Gabriel Katz, Ofira Zloto & Ruth Huna-Baron

  2. The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel

    Guy J. Ben Simon, Gabriel Katz, Ofira Zloto & Ruth Huna-Baron

  3. Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel

    Hana Leiba & Beatrix Hadas

  4. The Hebrew University Faculty of Medicine, Jerusalem, Israel

    Hana Leiba & Beatrix Hadas

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  1. Guy J. Ben Simon
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  2. Gabriel Katz
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Correspondence to Guy J. Ben Simon.

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Ben Simon, G.J., Katz, G., Zloto, O. et al. Age differences in clinical manifestation and prognosis of thyroid eye disease. Graefes Arch Clin Exp Ophthalmol 253, 2301–2308 (2015). https://doi.org/10.1007/s00417-015-3156-2

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  • DOI: https://doi.org/10.1007/s00417-015-3156-2

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