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

• Published in: International ophthalmology Vol. 43; no. 2; pp. 643 - 653
• Main Authors: Ozturk, Mine, Konuk, Onur, Tarlan, Bercin, Yalcın, Mehmet Muhittin, Arıbas, Yavuz Kemal, Toruner, Fusun Balos, Unal, Mehmet, Ayvaz, Goksun
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01-02-2023; Springer Nature B.V
• Subjects: Ablation; Decompression; Diagnosis; Evaluation; Graves disease; Graves Ophthalmopathy - diagnosis; Graves Ophthalmopathy - epidemiology; Graves Ophthalmopathy - therapy; Health services; Humans; Hyperthyroidism; Iodine 131; Iodine Radioisotopes; Medicine; Medicine & Public Health; Ophthalmology; Orbital Diseases; Original Paper; Patients; Retrospective Studies; Tertiary Care Centers; Thyroid; Thyroid diseases; Thyroid gland; Turkey - epidemiology; Turkey; Ophthalmopathy; Graves’ disease; Epidemiology; Graves’ orbitopathy; Thyroid
• ISSN: 1573-2630; 0165-5701; 1573-2630
• DOI: 10.1007/s10792-022-02468-2

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.