Noninflammatory Thyroid Eye Disease

Ugradar, Shoaib; Rootman, Daniel B.

doi:10.1097/iop.0000000000001087

Cited by 22 publications

(22 citation statements)

References 17 publications

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“…[19][20][21] There are, however, subsets of patients who have "active", progressive TED despite a low CAS. 176 These may represent Nunery's type 1, as well as Uddin's "white eye" expansion, "white eye" apex, and cicatricial passive patients. These subgroups typically do not express the classic signs of inflammation that dominate the clinical activity score.…”

Section: Chronic Tedmentioning

confidence: 99%

“…These subgroups typically do not express the classic signs of inflammation that dominate the clinical activity score. 22,23,176,177 It is unclear how these "active" patients with a low CAS will respond to teprotumumab as they were not included in the clinical trials. Future studies regarding outcomes of teprotumumab when stratified by disease subtypes may be clinically relevant.…”

Section: Chronic Tedmentioning

confidence: 99%

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Teprotumumab

Winn

Kersten

2021

Ophthalmology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Chronic Tedmentioning

confidence: 99%

Section: Chronic Tedmentioning

confidence: 99%

Teprotumumab

Winn

Kersten

2021

Ophthalmology

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“…According to this model, the activity peak would precede the severity peak by a few months. It is now known that not all cases of “active TED” are characterized by active measurable inflammatory signs, and that the relationship between inflammation and severity of outcome is not well established as shown in a series by Ugradar and colleagues [ 17 ]. Lim et al, in their study on TED in south-east Asian patients note that even patients with a new-onset TED, a VISA score of less than 4/10 and experiencing significant symptoms can be classified as active TED [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Choroidal Thickness in Thyroid Eye Disease: Comparison With Controls and Application in Diagnosing Non-Inflammatory Active Disease

Dave¹,

Natarajan²,

Reddy³

et al. 2021

Cureus

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Introduction Choroidal thickness is known to vary in various systemic diseases. In the current study, we aim to report the differences in choroidal thickness in thyroid eye disease (TED) and normals and its discriminatory value for differentiating various stages of TED. Methods Prospective, cross-sectional, non-interventional imaging study. In an institutional practice, 102 eyes of 51 patients were included and divided into five groups: normal controls (C), inactive TED (I), active TED (A), non-inflammatory active TED (NIA) and systemic thyroid disorder but no TED (SYS). Choroidal images were acquired using the swept-source optical coherence tomography (Topcon DRI OCT Triton) with automatic layer segmentation which provided an automatic measurement of the subfoveal choroidal thickness and the mean in nine subfields based on the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. One-way analysis of variance (ANOVA), Youden index and area under the receiver operating characteristic curves (AUROC) were reported. Results Central choroidal thickness in the A group was 279±37.52 microns and in the NIA group was 302.5±59.22 microns. Both were comparable to each other and significantly higher than the C, I and SYS groups (p<0.001). All ETDRS sub-fields showed significant AUROC to distinguish NIA from I. Most significant Youden index was for the inner nasal and central ETDRS subfields (0.55 and 0.61 respectively). Inner nasal sub-field showed 100% specificity while the central sub-field, showed 86.5% for predicting NIA. At a choroidal thickness of >266 microns, the central sub-field had the strongest discriminatory potential to predict NIA. Conclusion Choroidal thickness is greater in active and non-inflammatory active TED. The inner nasal and central ETDRS sub-fields have value in differentiating the non-inflammatory active TED eyes from the inactive eyes.

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“…In addition, there was a slight age imbalance between the two groups, as patients with non-DON were younger than patients with DON. However, studies have revealed that DON typically develops in an older population [ 7 , 11 , 27 ]; thus, a larger sample size may also compensate for this limitation.…”

Section: Discussionmentioning

confidence: 99%

Comparing isolated-check visual evoked potential, pattern visual evoked potential, and standard automated perimetry in dysthyroid optic neuropathy eyes

Tong

et al. 2020

Eye

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Objective To determine the diagnostic ability of isolated-check visual evoked potential (icVEP), pattern visual evoked potential (pVEP), and standard automated perimetry (SAP) between dysthyroid optic neuropathy (DON) and thyroid-associated ophthalmopathy (TAO) without DON (non-DON). Methods This is a case-control study, 49 bilateral patients (26 DON and 23 non-DON) were included. icVEP, pVEP, and SAP were conducted in all the subjects, icVEP parameters compared were signal-to-noise ratios (SNRs) under 8, 16, and 32% depth of modulation (DOM). pVEP parameters compared were amplitude and latency. SAP parameters were mean deviation (MD) and pattern standard deviation (PSD). The area under the receiver operating characteristic (ROC) curve (AUC), net reclassification index (NRI), integrated discrimination index (IDI), and decision curve analysis (DCA) were applied for analysis. Results In icVEP, values of SNR in DON were significantly smaller than non-DON (p < 0.05). In pVEP, P100 latent time in DON was significantly larger than non-DON (p = 0.0026). In SAP, value of PSD in DON was larger than non-DON (p = 0.0006), and value of MD in DON was smaller (p = 0.0007). AUC, NRI, and IDI among the three tests were not significantly different. DCA showed that SNR of icVEP under 8% DOM was the farthest from the two extreme curves. Conclusions icVEP, pVEP, and SAP have equal diagnostic capabilities to discern between DON and non-DON. In addition, icVEP may represent a significant ancillary diagnostic approach to DON detection, with more clinical benefit.

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Noninflammatory Thyroid Eye Disease

Cited by 22 publications

References 17 publications

Teprotumumab

Teprotumumab

Choroidal Thickness in Thyroid Eye Disease: Comparison With Controls and Application in Diagnosing Non-Inflammatory Active Disease

Comparing isolated-check visual evoked potential, pattern visual evoked potential, and standard automated perimetry in dysthyroid optic neuropathy eyes

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