Exophthalmos of patients with Graves' disease in Chinese of Taiwan

“…Um erro na medida da base resulta em diferença na exoftalmometria. A compressão excessiva contra os tecidos periorbitários pode acarretar em alterações de até 1mm na medição (15) . Esse erro pode aumentar quando há um edema ao redor da margem orbitária lateral, como na oftalmopatia de Graves (7) .…”

Section: Discussionunclassified

“…Migliori e Gladstone em 1984 e Dunsky em 1992 encontraram diferenças entre homens e mulheres nos valores da exoftalmometria. (13,18) No entanto, Tsai et al (15) não encontraram uma diferença significativa entre os sexos na população chinesa estudada, sendo 13,97 ±2,26mm a média encontrada para os homens e 13,86 ±2,39, a das mulheres. Nucci P et al em 1989 e Fledelius e Stubgaard em 1986 também não encontraram diferenças entre os valores entre homens e mulheres (17,19) .…”

Section: Discussionunclassified

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Valores da exoftalmometria média na população adulta da região do Grande ABC, São Paulo/Brasil

Moysés

Lucci

Júnior

et al. 2010

Rev. bras.oftalmol.

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RESUMOObjetivo: Estabelecer padrões de normalidade dos valores da exoftalmometria de ambos os olhos e da distância entre os rebordos orbitários laterais (base) em adultos jovens da população do Grande ABC São Paulo/Brasil. Métodos: Realizou-se a exoftalmometria com o exoftalmômetro de Hertel, em 129 pacientes do sexo feminino e 75 do sexo masculino, na faixa etária de 25 a 55 anos. Os pacientes foram separados em três grupos raciais (brancos, negros e pardos). Resultados: A variação da exoftalmometria encontrada na população em estudo foi de 10 a 23mm, média de 15,57 ±2,43mm. No sexo feminino a média foi de 15,42 ±2,40mm e no masculino, 15,83 ±2,47mm. Não se encontrou uma relação estatisticamente significativa entre os sexos feminino e masculino (p=0,25). Na raça branca a média foi de 15,57 ±2,46mm, na negra foi de 16,20 ±2,70mm e na parda foi de 15,02 ±2,01mm. A diferença foi estatisticamente significativa (p=0,008) entre as raças negra e parda. A medida da base variou de 104 a 125mm (média de 113,91 ±4,37mm). A diferença entre homens e mulheres foi estatisticamente significativa (p<0,001). Na raça branca a média da base encontrada foi de 112,18 ±4,02mm, na negra foi de 115,37 ±4,71mm e na parda, 115,18 ±3,66mm. A diferença da média da base foi estatisticamente significativa (p<0,001) entre as raças branca e negra e branca e parda. Nenhum paciente apresentou assimetria entre os dois olhos maior que 2mm. Conclusão: O padrão de normalidade da exoftalmometria encontrado para a população em estudo foi de 10 a 23mm e a base variou de 104 a 125mm.

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“…Data-based exophthalmos was established by exophthalmometer readings that were greater than 2 SDs above the reference values reported for age and sex (14,15) and race (16,17).…”

Section: Evaluations Of Orbital Diseasementioning

confidence: 99%

Radioiodine Therapy and Graves' Ophthalmopathy

et al. 2008

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Appearances of and increases in Graves' ophthalmopathy (GO) have been reported after treatment of patients with hyperthyroidism with radioiodine. We sought to determine the rates of appearance or increase in manifestations of GO in American patients treated with radioiodine for hyperthyroidism. Methods: The study population, which consisted of 76 patients (range, 10.6-72 y), included 61 women and individuals of diverse ethnicity. The patients were followed for 1 y after radioiodine treatment. The clinical activity score (CAS) included 10 items of ophthalmic change that were evaluated at 2 and 6 mo and at 1 y; appearance of a new item scored 1 point. We evaluated interactions of 6 covariates-prolonged hyperthyroidism, prolonged hypothyroidism, smoking, treatment with an antithyroid drug (ATD), and serum levels of thyroid-stimulating immunoglobulin (TSI) and of high free T 3 (FT 3 )-with the numbers of patients with 2 or more CAS points and with exophthalmometer readings increased by at least 2 mm. In addition, patients completed a scored quality-of-life (QOL) questionnaire at baseline and at 1 y to assess eye symptoms. Results: The mean CAS points for all patients at 2 mo was 0.63 and was not significantly different at 1 y. In 9 of 10 CAS items, there were few patients affected at 1 y and for the most part there were fewer patients affected than at baseline. However, exophthalmometer readings increased in 39% of patients by a mean of 2.6 mm. Individual patients frequently exhibited increases and decreases in item manifestations. Exophthalmometer readings decreased by 2 mm or less in 13%. Of the covariates, only hyperthyroidism prolonged by at least 2.5 mo was significantly associated with 2 or more CAS points at 1 y; no covariate was significantly associated with the development of increased exophthalmometer readings. Eye symptoms recorded in the QOL were insignificantly improved over the year; symptoms did not correlate with CAS points or with exophthalmometer readings. Conclusion: After radioiodine treatment, no substantial change was seen in manifestations of CAS items except for a modest increase in exophthalmometer readings in 39% of patients. Manifestations of CAS items frequently appeared and disappeared. Prolonged hyperthyroidism is best avoided. Ocular symptoms were insignificantly fewer at 1 y after radioiodine therapy. The observed changes do not warrant prophylactic treatment of patients with steroids.

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Exophthalmos of patients with Graves' disease in Chinese of Taiwan

Cited by 70 publications

References 22 publications

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Assessing Graves’ ophthalmopathy-specific quality of life in Korean patients

Valores da exoftalmometria média na população adulta da região do Grande ABC, São Paulo/Brasil

Radioiodine Therapy and Graves' Ophthalmopathy

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