Background. Due to low incidence of Graves' ophthalmopathy (GO) among children, the manifestation is poorly analyzed, posing a risk to late identification of insidious disease. Purposes. To identify predictive factors that may influence the development of GO in pediatric and young patients with Graves' disease (GD). Methods. A cross-sectional study of patients newly diagnosed with pediatric or juvenile GD during 2002–2012 was conducted at the Hospital of Lithuanian University of Health Sciences. Ocular evaluation was based on European Group on Graves' Orbitopathy survey. The ocular manifestations were analyzed in relation to demographic, environmental, and clinical factors. Results. In total, 130 patients with juvenile GD were included; 29.2% had GO. Median age at GD onset was 17 yrs (IQR 4–29). Main symptoms of GO were eyelids retraction (73.7%), proptosis (65.8%), injection of conjunctiva (42.1%), and eyeball motility disturbance (21.1%). Major significant and independent risk factors for GO development were high initial concentration of FT4 (OR = 5.963), TTHAb (OR = 6.358), stress (OR = 6.030), and smoking (OR = 7.098). Conclusion. The major factors that could influence GO development were smoking, stress, and increased levels of initial TRAb, FT4. Slight proptosis, retraction of eyelids, and conjunctive injection were found as predominant ophthalmological symptoms in juvenile GO.
Objective. The aim of the study was to assess visual acuity, refractive status, and eye proptosis in children and young adults with Graves' disease.
Material and Methods. We have done investigations of visual acuity, refraction, and eye proptosis in 16 children, 14 teenagers, and 49 adults with Graves' disease at Eye Clinic of Lithuanian University of Health Sciences Medical Academy. Data were compared with 14 children, 14 teenagers, and 35 adults of similar age without the same diseases (control group). Results. In the present study we observed a significant decrease of visual acuity in teenagers (0.73 ± 0.18, P = 0.001) and adults (0.7 ± 0.16, P = 0.001) with Graves' disease. Myopia was ascertained more frequent in teenagers (42.8 percent) and adults (44.9 percent) with Graves' disease. In our study exophthalmometer values were higher in children (15.94 ± 1.98 mm, P = 0.003), teenagers (17.28 ± 2.99 mm, P = 0.01), and adults (18.05 ± 2.91 mm, P = 0.001) in comparison with the controls.
Conclusions. The data we have found suggest that Graves' disease in children, teenagers, and adults has influence on vision acuity, refraction, and eye proptosis.
The aim of this study was to evaluate changes in extraocular muscle thickness and to assess its correlation with the degree of proptosis in patients with Graves’ ophthalmopathy (GO). Material and methods. A total of 242 patients (207 females and 35 males) with Graves’ ophthalmopathy were enrolled into the study (GO group). Their mean age was 53.83±14.49 years. In addition, we examined an age-matched (53.51±12.79 years) control group of 40 healthy persons. All the participants underwent ophthalmological examination, including eye protrusion measurement and ultrasonographic evaluation of extraocular muscles thickness. Results. The mean exophthalmos in the GO and control groups was 17.84±2.79 mm and 16.0±1.58 mm, respectively. The enlargement of inferior rectus muscle was recorded in 92.1% of patients, lateral rectus muscle in 81.2%, and medial rectus muscle in 50.8% (P<0.001). A significant correlation between exophthalmos and muscle thickness sum was found in the GO group (Spearman correlation coefficient, 0.515; P<0.0001). Conclusions. Graves’ ophthalmopathy is more frequent in medium-aged women than men. A significant enlargement of inferior, lateral, and medial straight muscles was noticed in the GO group. With increasing proptosis, the sum of the muscle thickness was increasing, and exophthalmos moderately correlated with muscle thickness sum.
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