The Clinical Characteristics of Thyroid Orbitopathy in Thyroid Dysfunction Patients in Korea

ABSTRACT

PURPOSE: To investigate the clinical manifestation of thyroid orbitopathy among patients with thyroid dysfunction. METHODS: A cross-sectional study was conducted at 24 general hospitals in Korea. All dysthyroid patients who visited the endocrinology clinic for 1 week were included. Data were collected during an interviewer-administered questionnaire. Thyroid orbitopathy was diagnosed in cases with relevant symptoms according to the VISA classification for which an eye examination was performed. Three hundred seventy-one patients who had thyroid orbitopathy out of 1986 dysthyroid patients were evaluated. RESULTS: Vision symptoms were presented in 10.5% of thyroid orbitopathy patients, inflammation symptoms in 43.1%, strabismus in 15.1%, and appearance and exposure symptoms in 86.3% of patients. Among the eye symptoms, proptosis was most prevalent in 56.9% of patients followed by eyelid retraction in 31.5%, diplopia in 15.1% and optic nerve dysfunction in 2.4% of patients. Median value of exophthalmometry in the thyroid orbitopathy group was 16 mm and 17 mm in the proptosis group. Patient self assessment for thyroid orbitopathy from the onset of the disease was "greatly improved" in 12.1% of patients, "improved" in 19.5%, "unchanged" in 51.2%, "worse" in 19.6%, and "much worse" in 1.0% of patients. CONCLUSIONS: Among dysthyroid patients, significant amount was found to have symptoms related with thyroid orbitopathy. The patients with thyroid orbitopathy, except for the mildest cases, need to be managed by a thyroid eye disease specialist for further assessment and care.