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Kahori Mizuno, Ai Kozaki, Chika Funaki, Gaku Ito, Rishu Inoue, Koichi Nishiyama, Toshu Inoue, Yoichi Inoue; Clinical Features of Japanese Elderly Patients with Dysthyroid Ophthalmopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5910.
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© ARVO (1962-2015); The Authors (2016-present)
The number of elderly patients with dysthyroid ophthalmopathy (DO) is small in comparison with patients in other age groups, and the clinical characteristics of these elderly patients are not well defined either. We evaluated the clinical features of Japanese elderly patients with DO.
We included 2468 Japanese patients with DO, who visited our hospital between 2009 and 2010. We classified them into 3 groups: elderly group (age >69 years; 67 patients; mean age, 74.5 years), adult group (20-69 years; 2314 patients; mean age, 42.4 years), and children group (<20 years; 87 patients; mean age, 16.1 years). All patients were evaluated for gender, subjective symptoms, measurement of proptosis by using Hertel exophthalmometry, and cross-sectional area of the 4 rectus muscles on magnetic resonance imaging.
The male to female ratio was 1:2 in the elderly group, 1:4 in the adult group, and 1:4 in the children group. The number of men in the elderly group was statistically greater than that in the other groups (P < .01). Subjective symptoms such as visual acuity loss and diplopia were observed in 50% and 79% of the patients in the elderly group, 32% and 30% of the patients in the adult group, and 24% and 11% of the patients in the children group, respectively. These symptoms were significantly severe in the elderly group (P < .01). Average value of proptosis was 15.4 ± 3.6 mm in the elderly group, 17.2 ± 3.1 mm in the adult group, and 18.5 ± 2.5 mm in the children group; this value was significantly lower in the elderly group than in other groups (P < .01).The average cross-sectional area of each of the 4 rectus muscles was significantly greater in the elderly group (P <.01).
Clinical features of Japanese elderly patients with DO revealed enlargement of extraocular muscles (EOM) despite mild proptosis. We considered that enlargement of the EOM in elderly patients contributed to a high incidence of dysthyroid optic neuropathy and diplopia. The incidence of DO in elderly patients may increase with an aging society in Japan.
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