Prognostic indicators for the development of strabismus among patients with graves' ophthalmopathy.
Prognostic indicators for the development of strabismus among patients with graves' ophthalmopathy.
复制标题
DOI：
10.1016/j.jcte.2017.06.005
复制
发表时间：
2017-09
影响因子：
3
通讯作者：
Rootman DB
中科院分区：
文献类型：
--
作者：
Lin TY;Li N;Yeh MW;Leung AM;Rootman DB
甲状腺眼病（Thyroid eye disease，TED）是Graves病（Graves' disease，GD）最常见的甲状腺外表现，是一种累及眼眶周围组织的自身免疫性炎症过程。由于患者外观的变化，TED是一种社交和视觉障碍，对生活质量有显著影响。这项研究的目的是评估斜视的预测因素，斜视是TED的一种严重表现。单机构回顾性病例对照研究。Graves眼病伴斜视组与Graves眼病不伴斜视组按年龄和性别1：1配对。2012年至2015年期间在UCLA接受斜视治疗的≥18岁重度Graves眼病患者。病例的合格标准是Graves眼病的诊断，随后诊断为斜视。使用条件Logistic回归，评估Graves病诊断后发生斜视的优势比。评估的预后指标包括人种、种族、吸烟（主动）、血清甲状腺过氧化物酶（TPO）抗体阳性、血清甲状腺球蛋白（Tg）抗体阳性、抗甲状腺药物使用和类固醇使用。研究样本（45例病例与45例对照1：1匹配）主要由患有TED的非西班牙裔、非拉丁裔高加索女性组成（平均值± SD年龄63.0 ± 13.1岁）。斜视的发生没有显著的预测因素，包括吸烟（主动）、血清甲状腺过氧化物酶（TPO）抗体阳性、血清甲状腺球蛋白（Tg）抗体阳性、抗甲状腺药物和类固醇使用。在本研究中，在诊断为TED后，未发现斜视（Graves眼病的严重表现）的显著预测因素。
Thyroid eye disease (TED), an autoimmune inflammatory process involving the orbital tissues around the eye, is the most common extra-thyroidal manifestation of Graves’ disease (GD). Due to changes in the patient’s appearance, TED is a socially and visually disabling condition with significant impacts on quality of life. The aim of this study is to assess predictors of strabismus, a severe manifestation of TED. Single-institution retrospective case-control study. Cases of Graves’ ophthalmopathy patients with strabismus were matched 1:1 to controls of Graves’ ophthalmopathy patients without strabismus by age and sex. Patients ≥18 years old with severe Graves’ ophthalmopathy who received their medical care at UCLA with strabismus between 2012 and 2015. Eligibility criteria for cases was a diagnosis of Graves’ ophthalmopathy with a subsequent diagnosis of strabismus. Using conditional logistic regression, the odds ratios of developing strabismus following the diagnosis of Graves’ disease were assessed. The prognostic indicators assessed include race, ethnicity, cigarette smoking (active), serum thyroid peroxidase (TPO) antibody positivity, serum thyroglobulin (Tg) antibody positivity, antithyroidal medication use, and steroid use. The study sample (45 cases 1:1 matched against 45 controls) was comprised primarily of non-Hispanic, non-Latino Caucasian women with TED (mean ± SD age 63.0 ± 13.1 years). There were no significant predictors for the development of strabismus, including cigarette smoking (active), serum thyroid peroxidase (TPO) antibody positivity, serum thyroglobulin (Tg) antibody positivity, antithyroidal medication, and steroid use. No significant predictors of strabismus, a severe manifestation of Graves’ ophthalmopathy, were identified following a diagnosis of TED in this study.