Skip to main content
Erschienen in: International Ophthalmology 2/2023

28.08.2022 | Original Paper

Clinical characteristics and the treatment modalities of Graves’ orbitopathy in a tertiary referral center in Turkey: changes over two decades

verfasst von: Mine Ozturk, Onur Konuk, Bercin Tarlan, Mehmet Muhittin Yalcın, Yavuz Kemal Arıbas, Fusun Balos Toruner, Mehmet Unal, Goksun Ayvaz

Erschienen in: International Ophthalmology | Ausgabe 2/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the changes in demographics, clinical findings, and treatment modalities in Graves’ orbitopathy (GO) patients at a tertiary referral center in Turkey over the last two decades.

Methods

The clinical data of 752 GO patients were evaluated retrospectively. Patients were divided into 2 groups according to the first ophthalmic examination date; Group 1(n:344) between January 1998 and December 2007 and Group 2(n:408) between January 2008 and December 2017.

Results

The number of nonsmokers was significantly higher in Group 2 (44.0 vs. 26.5%, p < 0.001). The time from the diagnosis of thyroid dysfunction and referral to our center was 32.4 months in Group 1 and 34.8 months in Group 2, (p = 0.166). The most common treatment of hyperthyroidism was antithyroid medications. Radioiodine ablation treatment rate was significantly lower in Group 2 (14.8 vs. 9.1%, p < 0.001). The time between the diagnosis of thyroid disease and orbital involvement was 22.0 vs. 26.6 months in Groups 1 and 2, respectively (p = 0.009). The time elapsed between the diagnosis of orbital disease and referral to our clinic was 21.0 months vs. 22.4 months in Group 1 and 2, respectively (p = 0.068). Orbital disease was most commonly mild, and inactive. Mild and moderate to severe GO and the mean Clinical Activity Score significantly increased, and the rate of sight-threatening disease and orbital decompression surgery significantly decreased in Group 2 (p = 0.042; p < 0.001, respectively).

Conclusions

Mild and inactive orbital disease was the most common form of GO. The severity of GO is declining over the last two decades in Turkey.
Literatur
4.
Zurück zum Zitat European Group of Graves O, Perros P, Baldeschi L, Boboridis K, Dickinson AJ, Hullo A, Kahaly GJ, Kendall-Taylor P, Krassas GE, Lane CM, Lazarus JH, Marcocci C, Marino M, Mourits MP, Nardi M, Orgiazzi J, Pinchera A, Pitz S, Prummel MF, Wiersinga WM (2006) A questionnaire survey on the management of Graves’ orbitopathy in Europe. Eur J Endocrinol 155(2):207–211. https://doi.org/10.1530/eje.1.02201CrossRef European Group of Graves O, Perros P, Baldeschi L, Boboridis K, Dickinson AJ, Hullo A, Kahaly GJ, Kendall-Taylor P, Krassas GE, Lane CM, Lazarus JH, Marcocci C, Marino M, Mourits MP, Nardi M, Orgiazzi J, Pinchera A, Pitz S, Prummel MF, Wiersinga WM (2006) A questionnaire survey on the management of Graves’ orbitopathy in Europe. Eur J Endocrinol 155(2):207–211. https://​doi.​org/​10.​1530/​eje.​1.​02201CrossRef
5.
Zurück zum Zitat Ippolito S, Cusini C, Lasalvia P, Gianfagna F, Veronesi G, Gallo D, Masiello E, Premoli P, Sabatino J, Mercuriali A, Lai A, Piantanida E, Tanda ML, Bartalena L (2021) Change in newly diagnosed Graves’ disease phenotype between the twentieth and the twenty-first centuries: meta-analysis and meta-regression. J Endocrinol Invest 44(8):1707–1718. https://doi.org/10.1007/s40618-020-01479-zCrossRefPubMed Ippolito S, Cusini C, Lasalvia P, Gianfagna F, Veronesi G, Gallo D, Masiello E, Premoli P, Sabatino J, Mercuriali A, Lai A, Piantanida E, Tanda ML, Bartalena L (2021) Change in newly diagnosed Graves’ disease phenotype between the twentieth and the twenty-first centuries: meta-analysis and meta-regression. J Endocrinol Invest 44(8):1707–1718. https://​doi.​org/​10.​1007/​s40618-020-01479-zCrossRefPubMed
6.
Zurück zum Zitat Tanda ML, Piantanida E, Liparulo L, Veronesi G, Lai A, Sassi L, Pariani N, Gallo D, Azzolini C, Ferrario M, Bartalena L (2013) Prevalence and natural history of Graves’ orbitopathy in a large series of patients with newly diagnosed graves’ hyperthyroidism seen at a single center. J Clin Endocrinol Metab 98(4):1443–1449. https://doi.org/10.1210/jc.2012-3873CrossRefPubMed Tanda ML, Piantanida E, Liparulo L, Veronesi G, Lai A, Sassi L, Pariani N, Gallo D, Azzolini C, Ferrario M, Bartalena L (2013) Prevalence and natural history of Graves’ orbitopathy in a large series of patients with newly diagnosed graves’ hyperthyroidism seen at a single center. J Clin Endocrinol Metab 98(4):1443–1449. https://​doi.​org/​10.​1210/​jc.​2012-3873CrossRefPubMed
7.
Zurück zum Zitat Perros P, Zarkovic M, Azzolini C, Ayvaz G, Baldeschi L, Bartalena L, Boschi A, Bournaud C, Brix TH, Covelli D, Ciric S, Daumerie C, Eckstein A, Fichter N, Fuhrer D, Hegedus L, Kahaly GJ, Konuk O, Lareida J, Lazarus J, Leo M, Mathiopoulou L, Menconi F, Morris D, Okosieme O, Orgiazzi J, Pitz S, Salvi M, Vardanian-Vartin C, Wiersinga W, Bernard M, Clarke L, Curro N, Dayan C, Dickinson J, Knezevic M, Lane C, Marcocci C, Marino M, Moller L, Nardi M, Neoh C, Pearce S, von Arx G, Toruner FB (2015) PREGO (presentation of Graves’ orbitopathy) study: changes in referral patterns to European group on graves’ orbitopathy (EUGOGO) centres over the period from 2000 to 2012. Br J Ophthalmol 99(11):1531–1535. https://doi.org/10.1136/bjophthalmol-2015-306733CrossRefPubMed Perros P, Zarkovic M, Azzolini C, Ayvaz G, Baldeschi L, Bartalena L, Boschi A, Bournaud C, Brix TH, Covelli D, Ciric S, Daumerie C, Eckstein A, Fichter N, Fuhrer D, Hegedus L, Kahaly GJ, Konuk O, Lareida J, Lazarus J, Leo M, Mathiopoulou L, Menconi F, Morris D, Okosieme O, Orgiazzi J, Pitz S, Salvi M, Vardanian-Vartin C, Wiersinga W, Bernard M, Clarke L, Curro N, Dayan C, Dickinson J, Knezevic M, Lane C, Marcocci C, Marino M, Moller L, Nardi M, Neoh C, Pearce S, von Arx G, Toruner FB (2015) PREGO (presentation of Graves’ orbitopathy) study: changes in referral patterns to European group on graves’ orbitopathy (EUGOGO) centres over the period from 2000 to 2012. Br J Ophthalmol 99(11):1531–1535. https://​doi.​org/​10.​1136/​bjophthalmol-2015-306733CrossRefPubMed
8.
Zurück zum Zitat European Group on Graves O, Wiersinga WM, Perros P, Kahaly GJ, Mourits MP, Baldeschi L, Boboridis K, Boschi A, Dickinson AJ, Kendall-Taylor P, Krassas GE, Lane CM, Lazarus JH, Marcocci C, Marino M, Nardi M, Neoh C, Orgiazzi J, Pinchera A, Pitz S, Prummel MF, Sartini MS, Stahl M, von Arx G (2006) Clinical assessment of patients with Graves’ orbitopathy: the European group on Graves’ Orbitopathy recommendations to generalists, specialists and clinical researchers. Eur J Endocrinol 155(3):387–389. https://doi.org/10.1530/eje.1.02230CrossRef European Group on Graves O, Wiersinga WM, Perros P, Kahaly GJ, Mourits MP, Baldeschi L, Boboridis K, Boschi A, Dickinson AJ, Kendall-Taylor P, Krassas GE, Lane CM, Lazarus JH, Marcocci C, Marino M, Nardi M, Neoh C, Orgiazzi J, Pinchera A, Pitz S, Prummel MF, Sartini MS, Stahl M, von Arx G (2006) Clinical assessment of patients with Graves’ orbitopathy: the European group on Graves’ Orbitopathy recommendations to generalists, specialists and clinical researchers. Eur J Endocrinol 155(3):387–389. https://​doi.​org/​10.​1530/​eje.​1.​02230CrossRef
10.
Zurück zum Zitat Bartalena L, Kahaly GJ, Baldeschi L, Dayan CM, Eckstein A, Marcocci C, Marino M, Vaidya B, Wiersinga WM, dagger E, (2021) The 2021 European group on graves’ orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves’ orbitopathy. Eur J Endocrinol 185(4):G43–G67. https://doi.org/10.1530/EJE-21-0479CrossRefPubMed Bartalena L, Kahaly GJ, Baldeschi L, Dayan CM, Eckstein A, Marcocci C, Marino M, Vaidya B, Wiersinga WM, dagger E, (2021) The 2021 European group on graves’ orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves’ orbitopathy. Eur J Endocrinol 185(4):G43–G67. https://​doi.​org/​10.​1530/​EJE-21-0479CrossRefPubMed
11.
Zurück zum Zitat Laurberg P, Pedersen KM, Vestergaard H, Sigurdsson G (1991) High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland. J Intern Med, 229 (5): 415–420. https://doi.org/10.1111/j.1365-2796.1991.tb00368.x Laurberg P, Pedersen KM, Vestergaard H, Sigurdsson G (1991) High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland. J Intern Med, 229 (5): 415–420. https://​doi.​org/​10.​1111/​j.​1365-2796.​1991.​tb00368.​x
17.
22.
Zurück zum Zitat Bartalena L, Baldeschi L, Boboridis K, Eckstein A, Kahaly GJ, Marcocci C, Perros P, Salvi M, Wiersinga WM, European Group on Graves O (2016) The 2016 European thyroid association/European Group on Graves’ orbitopathy guidelines for the management of Graves’ orbitopathy. Eur Thyroid J 5(1):9–26. https://doi.org/10.1159/000443828CrossRef Bartalena L, Baldeschi L, Boboridis K, Eckstein A, Kahaly GJ, Marcocci C, Perros P, Salvi M, Wiersinga WM, European Group on Graves O (2016) The 2016 European thyroid association/European Group on Graves’ orbitopathy guidelines for the management of Graves’ orbitopathy. Eur Thyroid J 5(1):9–26. https://​doi.​org/​10.​1159/​000443828CrossRef
27.
Zurück zum Zitat Bartley GB (1994) The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Trans Am Ophthalmol Soc 92:477–588PubMedPubMedCentral Bartley GB (1994) The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Trans Am Ophthalmol Soc 92:477–588PubMedPubMedCentral
29.
Zurück zum Zitat Prummel MF, Bakker A, Wiersinga WM, Baldeschi L, Mourits MP, Kendall-Taylor P, Perros P, Neoh C, Dickinson AJ, Lazarus JH, Lane CM, Heufelder AE, Kahaly GJ, Pitz S, Orgiazzi J, Hullo A, Pinchera A, Marcocci C, Sartini MS, Rocchi R, Nardi M, Krassas GE, Halkias A (2003) Multi-center study on the characteristics and treatment strategies of patients with Graves’ orbitopathy: the first European Group on Graves’ Orbitopathy experience. Eur J Endocrinol 148(5):491–495. https://doi.org/10.1530/eje.0.1480491CrossRefPubMed Prummel MF, Bakker A, Wiersinga WM, Baldeschi L, Mourits MP, Kendall-Taylor P, Perros P, Neoh C, Dickinson AJ, Lazarus JH, Lane CM, Heufelder AE, Kahaly GJ, Pitz S, Orgiazzi J, Hullo A, Pinchera A, Marcocci C, Sartini MS, Rocchi R, Nardi M, Krassas GE, Halkias A (2003) Multi-center study on the characteristics and treatment strategies of patients with Graves’ orbitopathy: the first European Group on Graves’ Orbitopathy experience. Eur J Endocrinol 148(5):491–495. https://​doi.​org/​10.​1530/​eje.​0.​1480491CrossRefPubMed
31.
Zurück zum Zitat Kahaly GJ (2017) Management of Moderately Severe Graves orbitopathy. In: Wiersinga WM Kahaly GJ eds. A Multidisciplinary Approach: Questions and Answers. 3rd edition (revised and expanded) . Karger, Basel, pp 140–176 Kahaly GJ (2017) Management of Moderately Severe Graves orbitopathy. In: Wiersinga WM Kahaly GJ eds. A Multidisciplinary Approach: Questions and Answers. 3rd edition (revised and expanded) . Karger, Basel, pp 140–176
Metadaten
Titel
Clinical characteristics and the treatment modalities of Graves’ orbitopathy in a tertiary referral center in Turkey: changes over two decades
verfasst von
Mine Ozturk
Onur Konuk
Bercin Tarlan
Mehmet Muhittin Yalcın
Yavuz Kemal Arıbas
Fusun Balos Toruner
Mehmet Unal
Goksun Ayvaz
Publikationsdatum
28.08.2022
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 2/2023
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-022-02468-2

Weitere Artikel der Ausgabe 2/2023

International Ophthalmology 2/2023 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Ophthalmika in der Schwangerschaft

Die Verwendung von Ophthalmika in der Schwangerschaft und Stillzeit stellt immer eine Off-label-Anwendung dar. Ein Einsatz von Arzneimitteln muss daher besonders sorgfältig auf sein Risiko-Nutzen-Verhältnis bewertet werden. In der vorliegenden …

Operative Therapie und Keimnachweis bei endogener Endophthalmitis

Vitrektomie Originalie

Die endogene Endophthalmitis ist eine hämatogen fortgeleitete, bakterielle oder fungale Infektion, die über choroidale oder retinale Gefäße in den Augapfel eingeschwemmt wird [ 1 – 3 ]. Von dort infiltrieren die Keime in die Netzhaut, den …

Bakterielle endogene Endophthalmitis

Vitrektomie Leitthema

Eine endogene Endophthalmitis stellt einen ophthalmologischen Notfall dar, der umgehender Diagnostik und Therapie bedarf. Es sollte mit geeigneten Methoden, wie beispielsweise dem Freiburger Endophthalmitis-Set, ein Keimnachweis erfolgen. Bei der …

So erreichen Sie eine bestmögliche Wundheilung der Kornea

Die bestmögliche Wundheilung der Kornea, insbesondere ohne die Ausbildung von lichtstreuenden Narben, ist oberstes Gebot, um einer dauerhaften Schädigung der Hornhaut frühzeitig entgegenzuwirken und die Funktion des Auges zu erhalten.   

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.