Quality of life of patients with thyroid eye disease: 3-year follow-up in a multidisciplinary clinic in Israel
Tóm tắt
Changes in the quality of life (QOL) of patients with thyroid eye disease (TED) were examined during a 3-year follow-up in a multidisciplinary eye clinic, and factors that may improve QOL were identified. A retrospective review of medical records of all patients who attended the TED clinic at Sheba Medical Center, Israel, from May 2016 to May 2019 was performed. The retrieved data included demographics, comprehensive ophthalmic examination findings, clinical activity scores (CAS), laboratory test results, and QOL assessments by the Graves’ Orbitopathy QOL (GO-QOL) questionnaire. One hundred thirty-two TED clinic patients were examined. Thirty patients (22.72%) received medical treatment consisting of steroids according to the European Group on Graves’ Orbitopathy (EUGOGO) protocol, high-dose steroids, or immunosuppressive drugs. Twenty-eight patients (21.21%) underwent surgical rehabilitation (decompression, strabismus, or eyelid surgery). There was a significant increase in total QOL score after steroid treatment according to the EUGOGO protocol, after decompression surgery, and after strabismus surgery compared to pre-treatment total QOL (p=0.04, p=0.021, and p=0.042, respectively, matched pairs). In addition, there were significant positive correlations between the changes in the total QOL score and the change in thyroid-stimulating immunoglobulin (TSI) as well as the change in CAS among the patients who underwent medical and surgical interventions. QOL improved significantly after medical/surgical treatments. A change in the CAS and in the TSI may also correlate with change in QOL. Periodic evaluation of TED patients’ QOL is recommended for enhanced and more comprehensive management.
Tài liệu tham khảo
Bahn RS (2010) Graves’ ophthalmopathy. N Engl J Med 362(8):726–738
Bahmani-Kashkouli M, Pakdel F, Astaraki A et al (2009) Quality of life in patients with thyroid eye disease. J Ophthalmic Vis Res 4:164–168
Gerding MN, Terwee CB, Dekker FW et al (1997) Quality of life in patients with Graves’ ophthalmopathy is markedly decreased: measurement by the medical outcomes study instrument. Thyroid 7:885–889
Estcourt S, Quinn AG, Vaidya B (2011) Quality of life in thyroid eye disease: impact of quality of care. Eur J Endocrinol 164:649–655
Wiersinga WM, Prummel MF, Terwee CB (2004) Effects of Graves’ ophthalmopathy on quality of life. J Endocrinol Investig 27:259–264
Bradley EA, Sloan JA, Novotny PJ et al (2006) Evaluation of the National Eye Institute visual function questionnaire in Graves’ ophthalmopathy. Ophthalmology 113(8):1450–1454
Mourits MP, Prummel MF, Wiersinga WM, Koornneef L (1997) Clinical activity score as a guide in the management of patients with Graves’ ophthalmopathy. Clin Endocrinol 47:9–14
Bartalena L, Baldeschi L, Dickinson A et al (2008) Consensus statement of the European Group on Graves’ Orbitopathy (EUGOGO) on management of GO. Eur J Endocrinol 158:273–285
Bartalena L, Baldeschi L, Boboridis K et al (2016) The 2016 European Thyroid Association/European Group on Graves’ Orbitopathy guidelines for the management of graves’ orbitopathy. Eur Thyroid J 5:9–26
Iacobæus L, Sahlin S (2016) Evaluation of quality of life in patients with Graves’ ophthalmopathy, before and after orbital decompression. Orbit 35:121–125
Jellema HM, Merckel-Timmer E, Kloos R et al (2014) Quality of life improves after strabismus surgery in patients with Graves’ orbitopathy. Eur J Endocrinol 170:785–789
Jellema HM, Saeed P, Mombaerts I et al (2017) Objective and subjective outcomes of strabismus surgery in Graves’ orbitopathy: a prospective multicentre study. Acta Ophthalmol 95:386–391
Kashkouli M, Heidari I, Pakdel F et al (2011) Change in quality of life after medical and surgical treatment of Graves’ ophthalmopathy. Middle East Afr J Ophthalmol 18:42
Wickwar S, McBain H, Ezra DG et al (2015) The psychosocial and clinical outcomes of orbital decompression surgery for thyroid eye disease and predictors of change in quality of life. Ophthalmology 122:2568–76.e1
Verity DH, Rose GE (2013) Acute thyroid eye disease (TED): principles of medical and surgical management. Eye (Lond) 27(3):308–19
Vogel A, Elberling TV, Hørding M et al (2007) Affective symptoms and cognitive functions in the acute phase of Graves’ thyrotoxicosis. Psychoneuroendocrinology 32:36–43
Ponto KA, Kanitz M, Olivo PD et al (2011) Clinical relevance of thyroid-stimulating immunoglobulins in Graves’ ophthalmopathy. Ophthalmology 118:2279–2285
Lytton SD, Li Y, Olivo PD et al (2010) Novel chimeric thyroid-stimulating hormone-receptor bioassay for thyroid-stimulating immunoglobulins. Clin Exp Immunol 162:438–446