Correlation of TED Laterality with Thyroid Status among Thyroid Eye Disease (TED) Patients in a Tertiary Hospital in Indonesia
Downloads
Introduction: Thyroid eye disease (TED), an autoimmune thyroid disorder, is prevalent in Asian countries and exhibits a variety of manifestations. Orbital involvement in TED is usually bilateral but may occur unilaterally in some cases. While it is commonly associated with hyperthyroidism, it also manifests in individuals with hypothyroidism or euthyroidism. The purpose of this study was to investigate the relationship between TED laterality and thyroid status in TED patients treated at the Eye Oncology Clinic of Dr. Soetomo General Academic Hospital in Surabaya, Indonesia.
Methods: The study was retrospective, analytical and observational. Patients diagnosed with TED who were treated at Dr. Soetomo General Academic Hospital between January 2019 and December 2021 were the focus of this study. SPSS analyses of medical records that satisfied the sample criteria were used to compile the data for this study.
Results: There were 88 samples that were dominated by females (57.95%) and aged 41 – 50 (32.96%). Proptosis was the most common clinical manifestation (94.32%), with compressive optic neuropathy was the least common (3,41%). Eyelid retraction occurred in only 22.7% of the patients. TED was categorized into unilateral (44.32%) and bilateral (50%). The majority had hyperthyroidism (70.45%), followed by euthyroidism (25%), and hypothyroidism (4.55%). It was found that there was a significant correlation between thyroid status and TED laterality. Compared to euthyroidism, abnormal thyroid conditions such as hyperthyroidism and hypothyroidism develop bilateral TED more frequently than normal thyroid conditions.
Conclusion: There was a correlation between TED laterality and thyroid status among patient TED.
Ackuaku-Dogbe E, Akpalu J, Abaidoo B. 2017. Epidemiology and clinical features of thyroid-associated orbitopathy in accra. Middle East African Journal of Ophthalmology, 24(4):183. https://doi.org/10.4103/MEAJO.MEAJO_91_17.
Bahn RS. 2010. Mechanisms of disease graves' ophthalmopathy. The New England journal of medicine 362(8):738. https://doi.org/10.1056/NEJMRA0905750.
Bartalena L and Piantanida E. 2016. Cigarette smoking: number one enemy for Graves ophthalmopathy. Polish Archives of Internal Medicine 126(10):725–726. https://doi.org/10.20452/pamw. 3592.
Boesoirie SF, Kuntorini MW, Noorsanti AD, et al. 2012. Karakteristik penderita grave's ophthalmopathy di pusat mata nasional rumah sakit mata Cicendo Bandung. Jurnal Oftalmologi 1(1):1–6.
Chin YH, Ng CH, Lee MH et al. 2020. Prevalence of thyroid eye disease in Graves' disease: A meta-analysis and systematic review. Clinical Endocrinology 93(4):363–374. https://doi.org/10.1111/cen.14296.
Das L, Singh U, Malhotra B, et al. 2022. Thyroid eye disease with concurrent orbital lymphoma: a radiological surprise. Endocrinology, Diabetes & Metabolism Case Reports 2022: 21-0109. https://doi.org/10.1530/edm-21-0109.
Eckstein AK, Lösch C, Glowacka D, et al. 2009. Euthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical Graves ophthalmopathy. British Journal of Ophthalmology 93(8):1052–1056. https://doi.org/10.1136/bjo.2007 .137265.
Eshraghi B, Pourazizi M, Abbasi M, et al. 2023. A comparison between bilateral and unilateral thyroid eye disease. International Ophthalmology 43(8):2957-2962. https://doi.org/10.1007/s10792-023-02702-5.
Hasibuan NC, Yusran M, Himayani R. 2018. Penatalaksanaan thyroid eye disease pada laki-laki usia 51 tahun. Medical Journal of Lampung University 7(3):158-162.
Hiromatsu Y, Eguchi H, Tani J, et al. 2014. Graves' ophthalmopathy: epidemiology and natural history. Internal Medicine 53(5):353-60. https://doi.org/10.2169/internal medicine.53.1518.
Ho TC, Maamari RN, Kossler AL, et al. 2023. Outcomes of patients with thyroid eye disease partially treated with teprotumumab. Ophthalmic Plast Reconstr Surg 39(2):150-155. doi: 10.1097/IOP.0000000000002267.
Jang SY, Lee SY, Lee EJ, et al. 2012. Clinical features of thyroid-associated ophthalmopathy in clinically euthyroid Korean patients. Eye (Lond) 26(9):1263–1269. https://doi.org/ 10.1038/eye.2012.132.
Kashkouli MB, Kaghazkanani R, Heidari I, et al. 2011. Bilateral versus unilateral thyroid eye disease. Indian Journal of Ophthalmology 59(5):363-366. https://doi.org/10.4103/0301-4738.83612.
Khalilzadeh O, Noshad S, Rashidi A. 2011. Graves' ophthalmopathy: a review of immunogenetics. Current Genomic 12(8):564–575.
Khurana AK, Sunder S, Ahluwalia BK, et al. 1992. A clinico-investigative profile in Graves' ophthalmopathy. Indian Journal of Ophthalmology 40(2):56-58.
Lim NCS, Sundar G, Amrith S, et al. 2015. Thyroid eye disease: a Southeast Asian experience. British Journal of Ophthalmology 99(4):512–518. https://doi.org/10.1136/ bjophthalmol-2014-305649.
Lim SL, Lim AKE, Mumtaz M, et al. 2008a. Prevalence, risk factors, and clinical features of thyroid-associated ophthalmopathy in multiethnic Malaysian patients with Graves' disease. Thyroid: official journal of the American Thyroid Association 18(12):1297–1301. https://doi.org/10.1089/THY. 2008.0044.
Mcalinden C. 2014. An overview of thyroid eye disease. Eye Vis (Lond)1:9. https://doi.org/10.1186/s40662-014-0009-8.
Mitchell AL and Pearce SHS. 2013. Autoimmune thyroid diseases. In Clinical Immunology: Principles and Practice: Fourth Edition, p 837–846.
Muñoz-Ortiz J, Sierra-Cote MC, Zapata-Bravo E, et al. 2020. Prevalence of hyperthyroidism, hypothyroidism, and euthyroidism in thyroid eye disease: a systematic review of the literature. Systematic reviews 9(1):201. https://doi.org/10.1186/S13643-020-01459-7.
Muralidhar A, Das S, Tiple S. 2020. Clinical profile of thyroid eye disease and factors predictive of disease severity. Indian Journal of Ophthalmology 68(8):1629. https://doi.org/10.4103/IJO. IJO_104_20.
Murchison AP, Sires BA, Jian-Amadi A. 2009. Margin Reflex distance in different ethnic groups. Archives of Facial Plastic Surgery 11(5):303–305. https://doi.org/10.1001/archfaci.2009.303.
Nugroho WYA, Limantoro C, Arimadyo AK. 2019. Hubungan faktor risiko terhadap kejadian ophthalmopathy graves. Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) 8(4):1248–1256. https://doi.org/10.14710/ DMJ.V8I4.25371.
Patricia AG, Sidik M, Nusanti S. 2015. Karakteristik klinis dan evaluasi hasil pengobatan pasien oftalmopati graves di Divisi Neuro Oftalmologi rumah sakit Cipto Mangunkusumo periode Januari 2013 – Desember 2014. RSCM FKUI.
Ponto KA, Binder H, Diana T, et al. 2015. Prevalence, phenotype, and psychosocial well-being in euthyroid/hypothyroid thyroid-associated orbitopathy. Thyroid 25(8):942–948. https://doi.org/10.1089/thy. 2015.0031.
Ramesh S, Zhang QE, Sharpe J, et al. 2023. Thyroid eye disease and its vision-threatening manifestations in the academy IRIS registry: 2014-2018. Am J Ophthalmol 253:74-85. doi: 10.1016/j.ajo.2023.04.013.
Reddy SVB, Jain A, Yadav SB, et al. 2014. Prevalence of Graves' ophthalmopathy in patients with Graves' disease presenting to a referral centre in north India. The Indian Journal of Medical Research 139(1):99–104.
Restiadi K. 1994. Prevalensi dan pola penyebaran oftalmopati graves di poliklinik mata RSUD Dr. Soetomo Surabaya. Universitas Airlangga.
Åžahlı E and Gündüz K. 2017. Thyroid-associated Ophthalmopathy. Turkish Journal of Ophthalmology 47(2):94. https://doi.org/10.4274/TJO.80688.
Shah SS and Patel BC. 2023. Thyroid Eye Disease. StatPearls. Available at https://pubmed.ncbi.nlm.nih.gov/35881739/. Accessed on 12 June 2023.
Simon GJB, Syed HM, Douglas R, et al. 2004. Extraocular muscle enlargement with tendon involvement in thyroid-associated orbitopathy. American Journal of Ophthalmology 137(6):1145–1147. https://doi.org/10.1016/ j.ajo.2004.01.033.
Soebagjo HD. 2015. Thyroid Associated Orbitopathy. Surabaya: Global Persada Press.
Stan MN and Bahn RS. 2010. Risk factors for development or deterioration of Graves' ophthalmopathy. Thyroid: official journal of the American Thyroid Association 20(7):777–783. https://doi.org/10.1089/ THY.2010.1634.
Subramaniam DL, Yadalla D, Rajagopalan J. 2023. Are severe forms of thyroid eye disease common in the indian population? Clinical characteristics of 136 patients from a Tertiary Eye Care Centre. Indian Journal of Endocrinology and Metabolism 27(1):56. https://doi.org/10.4103/IJEM.IJEM_280_21.
Thyparampil P and Yen MT. 2016. Compressive optic neuropathy in thyroid eye disease. International Ophthalmology Clinics 56(1):51–67. https://doi.org/10.1097/IIO.0000000000000096.
Tsiogka A, Petrou P, Droutsas K, et al. 2023. hertel exophthalmometry values in a greek adult outpatient clinic-based population: association with demographic factors and systemic disease. Cureus15(2):e35027. doi: 10.7759/cureus.35027.
Weiler DL. 2017. Thyroid eye disease: a review. Clinical and Experimental Optometry. Blackwell Publishing Ltd, p 20–25. Available at https://doi.org/10.1111/cxo.12472.
Copyright (c) 2024 Zahirah Siti Lutfiyah, Delfitri Lutfi, Hermawan Susanto, Sutjipto
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) Author
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions.
3. The formal legal aspect of journal publication accessibility refers to Creative Commons Atribution-Share Alike 4.0 (CC BY-SA).
