Thyroid eye disease with choroidal folds

Ann Q Tran; Sandy X Zhang-Nunes; Kenneth Cahill; Chrisfouad R Alabiad; Erin M Shriver; Tiffany Ho; David A Weinberg; Steven M Couch; Dianne M Schlachter; John Nguyen; Sara T Wester

doi:10.1080/01676830.2020.1756347

Journal article

Thyroid eye disease with choroidal folds

Ann Q Tran, Sandy X Zhang-Nunes, Kenneth Cahill, Chrisfouad R Alabiad, Erin M Shriver, Tiffany Ho, David A Weinberg, Steven M Couch, Dianne M Schlachter, John Nguyen, …

Orbit (Amsterdam), Vol.40(3), pp.206-214

05/04/2021

DOI: 10.1080/01676830.2020.1756347

PMID: 32326785

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Abstract

Purpose: To determine the clinical course of patients with chorioretinal folds (CRF) in thyroid eye disease (TED). Methods: A multi-center retrospective case series of patients with TED who developed CRF. Results: Ten patients (17 eyes) with CRF related to TED were identified. The mean age of presentation was 59.3 ± 8.3 years old. The majority of patients were male (70%), hyperthyroid (70%), hyperopic (53%), had a history of radioactive iodine (60%), and currently on methimazole treatment (30%). Three patients (3 eyes) had unilateral involvement of CRF with bilateral TED. The average clinical activity score was 3.6 ± 2.1 at the time of presentation. The most commonly enlarged extraocular muscles were medial (76%), inferior (64%), superior (64%) and lateral rectus (35%). Compressive optic neuropathy was seen in 47% of eyes. Treatment included oral prednisone (70%), orbital decompression (59%), thyroidectomy (20%) and tocilizumab (10%). The CRF did not resolve over a follow up period of 24.7 ± 23.7 months in 70% of eyes. There was no significant difference in average axial length (25.7 ± 4.9 mm) and optic nerve to optic strut distance (37.8 ± 3.9 mm) between patients with CRF and the eight age-and sex-matched TED control patients without CRF (p = 0.81 and 0.65 respectively). A univariable and multivariable analysis found an enlarged inferior rectus as a factor in TED patients with persistent CRF. Conclusions: CRF are often an indicator of visually threatening situations and often do not resolve despite treatment of TED.

Chorioretinal folds

choroidal folds

Grave's ophthalmopathy

thyroid eye disease

thyroid orbitopathy

Details

Title: Subtitle: Thyroid eye disease with choroidal folds
Creators: Ann Q Tran - University of Miami
Sandy X Zhang-Nunes - USC Roski Eye Institute
Kenneth Cahill - The Ohio State University Wexner Medical Center
Chrisfouad R Alabiad - University of Miami
Erin M Shriver - University of Iowa
Tiffany Ho - Department of Ophthalmology, USC Roski Eye Institute, Los Angeles, California, USA
David A Weinberg
Steven M Couch - Washington University in St. Louis
Dianne M Schlachter - Oakland University
John Nguyen - West Virginia University
Sara T Wester - University of Miami
Resource Type: Journal article
Publication Details: Orbit (Amsterdam), Vol.40(3), pp.206-214
DOI: 10.1080/01676830.2020.1756347
PMID: 32326785
NLM abbreviation: Orbit
ISSN: 0167-6830
eISSN: 1744-5108
Publisher: Taylor & Francis
Grant note: name: NIH Center Core Grant, award: P30EY014801
Language: English
Date published: 05/04/2021
Academic Unit: Otolaryngology; Ophthalmology and Visual Sciences
Record Identifier: 9984187352402771

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