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

ABSTRACT

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