Background/objectives: Thyroid eye disease (TED), which can lead to severe sequelae, can involve either one eye or both eyes. The importance of knowing the distinction between laterality rests on the risk that either presentation is associated with a more severe form. It is our aim to investigate differences in patient characteristics and presentations between unilateral and bilateral TED. Methods: Cross-sectional study on clinically diagnosed TED patients from December 2013 to April 2018. Patients' sociodemographic factors, medical history, presentation, severity, and activity between unilateral TED and bilateral TED were compared. Results: 65 patients were included (unilateral TED: n = 40, 61.5%; bilateral TED: n = 25, 38.5%). Unilateral and bilateral TED were not different with regards to age, gender, family history of thyroid disease, comorbidities, and smoking status. There was nearly six times the likelihood of methimazole intake being associated with bilateral TED (odds ratio [OR] = 5.80, p = 0.02). Both groups were similar in almost all general presentation, orbital inflammation signs, and manifestations of lid retraction. The exception being blurred vision that was more common among bilateral TED patients (OR = 4.80, p = 0.04). There were also no differences between both groups in terms of thyroid hormones (TSH: p = 0.84; freeT4: p = 0.12), severity (p = 0.61), and activity (p = 0.99). Conclusions: Our study found unilateral TED to be more prevalent, while ongoing methimazole treatment and blurred vision are associated with bilateral TED. Our findings add to the growing evidence suggesting that the laterality of TED is not a factor in differentiating levels of activity or severity.
Risk factors and disease characteristics of TED cases at EAMC coincide with local published journals, except for significant correlation with male sex and TRAb titers showing the variability of the disease and the need for further studies.
Objective: To present a case report of asymptomatic post-traumatic chronic hypotony in which the cause was undetected until phacoemulsification. Methodology: Case report. Results: A 55-year-old female’s left eye suffered blunt trauma causing hyphema and iritis, which were successfully managed; however, up to a year after, the intraocular pressure (IOP) ranged from 3 to 5 mmHg and the anterior chamber remained very shallow (Van Herick grade 4) with the lens–iris diaphragm pushed anteriorly with difficulty assessing the angles for recession or clefts . Visual acuity was initially 20/20 upon resolution of the hyphema but worsened to 20/40 a year after, presumably due to a developing cataract. Periodic dilated fundus examinations revealed no hypotony maculopathy or choroidal effusions. Prior to phacoemulsification, ultrasound biomicroscopy (UBM) revealed 360 degrees of mild peripheral choroidal effusions. During phacoemulsification, after intraocular lens insertion, direct gonioscopy revealed a supero-nasal cyclodialysis cleft (2 clock hours) and this was repaired intraoperatively with direct cyclopexy through a partial thickness scleral flap. Postoperatively, the vision improved to 20/20 without correction and the IOP normalized to 16 to 18 mmHg. Conclusion: Chronic hypotony post-trauma may be asymptomatic and the cause may not be clinically evident and may be detected by UBM (choroidal effusion). In our case, the proximate aetiology (cyclodialysis cleft) of the effusion was only observed intraoperatively after phacoemulsification for which cyclopexy was performed which increased the IOP to physiologic levels.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.