Background: Graves ophthalmopathy is the most common extra thyroidal manifestation of
graves disease. In extremely rare instances, it is also seen in hypothyroid or euthyroid patients
with chronic autoimmune thyroiditis.
Aim & Objective: To study the clinical profile of Thyroid ophthalmopathy at tertiary care
hospital. The main objective of this study was to know the occurrence of thyroid
ophthalmopathy in hyperthyroid and hypothyroid patients, to study the clinical profile and
thyroid status, to know the clinical scoring of thyroid ophthalmopathy, to study the severity
of ophthalmopathy and its correlation with TFT’s and Thyroid antibodies and to know the
radiological features of thyroid ophthalmopathy and its correlation with clinical features.
Methodology: Present study was a Crosssectional Observational study. Study was conducted
at outpatient department and all wards at Dr DY Patil Medical College and Hospital, DY Patil
Vidyapeeth, Pimpri, Pune.
Results: Majority of cases were hyperthyroid (70%) and minor being hypothyroid (30%).
Majority 65% were females and 35% were males. Among hypothyroid cases (n=30), symptoms seen were 26.6% had fatigue, 20% had dry skin, 20% had constipation,13.3% had
weight gain, 10% had cold intolerance and 10% had hoarsness of voice. And those among
hyperthyroid cases 45.7% had weightloss, 25.7% had tremors, 18.5% had palpitations, 10%
had heat intolerance. 40% cases had eye symptoms, among total 100 patients 18% ha
dretrobulbardiscomfort,11%had lacrimation, 8% had photophobia, and 3% had milddiplopia.
Among eye signs 25% had eyelid retraction, 8% had extra ocular muscle dysfunction, 7% had
eyelid oedema. Thyroid antibody (TPO) in hyperthyroid was positive in 70% and among
hypothyroid 73.3% were positive. On MRI orbit in hyperthyroid cases 48.5% had positive
findings and all hypothyroid cases had normal study report.69%of exopthalmometry findings
were normal and 31% were proptosis. 96.7% had bilateral proptosis and 3.2% had unilateral
proptosis. No SPECS classification showed that 40 cases had soft tissue involvement, 31
hadproptosis, 31 had eye muscle involvement. Ophthalmopathy was seen among 57.1%
among hyperthyroid cases (40 cases). And 0% among hypothyroid cases. (p<0.001) shows
statistical significance. Present study showed that among 40 cases having ophthalmopathy 36
had TPO positive and 4 were negative. On MRI those having ophthalmopathy (n=40)
77.5% had extra ocular muscle enlargement,7.5% had increase in retroocular fat. Antithyroid
treatment was given in 70% cases those were hyperthyroid and thyroxine was given to
hypothyroid cases 30%.100%were given dark glasses, 95% lubricating drops and 30% were
given steroids.
Conclusion: Thyroid ophthalmopathy is an autoimmune disease which can cause vision loss
and reduced quality of life. Thyroid eye disease is more common in females than males and
hyperthyroidism being commonest cause of thyroid eye disease in our setup. Developments
in understanding of the pathophysiology of Thyroid ophthalmopathy led to a fundamental
change in the management. Systemic thyroid disease should be managed in all thyroid
patients. Hyperthyroidism and disease activity are risk factors for severe and sight
threatening disease and hence close follow-up and prompt detection and management with
adequate antithyroid drugs is required especially in newly diagnosed hyperthyroid patients.
Keywords: Thyroid, hyperthyroid, thyroxine, Thyroidantibody(TPO), lacrimation
Publication date: 15/02/2022
https://ijbpas.com/pdf/2022/February/MS_IJBPAS_2022_FEB_SPCL_1040.pdf
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https://doi.org/10.31032/IJBPAS/2022/11.2.1040
