Journal article
Thyroid eye disease with choroidal folds
Orbit (Amsterdam), Vol.40(3), pp.206-214
05/04/2021
DOI: 10.1080/01676830.2020.1756347
PMID: 32326785
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.
Details
- Title: Subtitle
- Thyroid eye disease with choroidal folds
- Creators
- Ann Q Tran - University of MiamiSandy X Zhang-Nunes - USC Roski Eye InstituteKenneth Cahill - The Ohio State University Wexner Medical CenterChrisfouad R Alabiad - University of MiamiErin M Shriver - University of IowaTiffany Ho - Department of Ophthalmology, USC Roski Eye Institute, Los Angeles, California, USADavid A Weinberg - Eye CenterSteven M Couch - Washington University in St. LouisDianne M Schlachter - Oakland UniversityJohn Nguyen - West Virginia UniversitySara T Wester - University of Miami
- Resource Type
- Journal article
- Publication Details
- Orbit (Amsterdam), Vol.40(3), pp.206-214
- Publisher
- Taylor & Francis
- DOI
- 10.1080/01676830.2020.1756347
- PMID
- 32326785
- ISSN
- 0167-6830
- eISSN
- 1744-5108
- 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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