Change in quality of life after medical and surgical treatment of Graves' ophthalmopathy

To assess the changes in quality of life [QOL] of patients after treatment of their Graves' ophthalmopathy [GO]. In this prospective, cross-sectional study, the GO-QOL questionnaire was completed by 67 subjects before and at least 6 months after steroid treatment [61 subjects, group 1] or optic neuropathy orbital decompression [6 subjects, group 2]. Visual, psychosocial, education and counseling scores [higher score = better health], GO severity and clinical activity scores and minimal clinically important difference [MCID] were recorded and analyzed for correlation and statistical significance. A P-value <0.05 was considered statistically significant. The mean age of patient enrolled in the study was 38.3 years, with 43 females [64.2%]. The mean duration of thyroid dysfunction and GO were 40.1 and 26.5 months, respectively. Two treatment groups were similar for all the variables [0.06 < P < 0.9], except for higher mean age in the orbital decompression group [45.2 versus 37.7 years] [P = 0.03]. Mean severity, activity, visual function and psychosocial function scores significantly improved in group 1 [steroid group] [P < 0.05, all cases]. A significant improvement in clinical activity score and psychosocial scores occurred in group 2 [decompression group] [P < 0.05]. MCID was achieved in two-thirds of the patients, with no significant difference between groups [P > 0.05]. There was no significant effect of duration of thyroid disease and GO and severity and activity of GO on QOL scores either before or after treatment [P > 0.05, all cases]. Steroid treatment and orbital decompression significantly improve the QOL in GO. Duration, severity and activity of GO did not have a significant impact on the QOL

Quality of life in patients with thyroid eye disease

To evaluate quality of life [QOL] before and after corticosteroid therapy for thyroid eye disease [TED] and to determine the impact of the disease on QOL. A modified TED-QOL questionnaire was completed by consecutive patients before and at least 6 months after steroid therapy. All patients were clinically and biochemically euthyroid during the course of the study. QOL was assessed in subscales of visual function, psychosocial, and educational/counseling; TED was classified by severity score [NOSPECS] and Mourits' clinical activity score. Overall, 61 patients including 18 [29.5%] male and 43 [70.5%] female subjects with mean age of 37.3 +/- 13.7 [range, 18-33] years were enrolled. Mean duration of thyroid dysfunction and TED were 40.1 +/- 44.8 and 26.5 +/- 38.2 months, respectively. Mean disease severity and activity significantly decreased, and visual and psychosocial function scores significantly improved following corticosteroid therapy for TED. Psychosocial score was significantly worse than visual function score before but not after steroid treatment. Linear regression analysis and Spearman correlation test showed no significant correlation between duration of thyroid dysfunction, duration of TED, disease severity and activity on one hand, and QOL scores on the other hand, before or after treatment. TED seems to adversely affect psychosocial activity more than visual function. Corticosteroid therapy significantly improves QOL. No significant correlation seems to exist between QOL scores and the severity or activity of TED