Abstract
Purpose::
Graves’ ophthalmopathy (GO) and Graves’ disease (GD) are closely associated diseases and may be caused by the same autoinmune process. An explanation for this may be the presence of auto-antibodies (Ab) reacting with an auto antigen in the orbit and the thyroid gland, like the TSH-receptor. The purpose of this study was to see if the initial levels of TSI (TSH receptor antibodies) were associated with the presence of GO during the follow up period, with findings like proptosis, keratopathy or strabismus in children younger than 18 years old.
Methods::
Retrospective study including all the patients with diagnosis with GD between 2000 and 2006, with titers of TSI at the time of diagnosis. The ocular findings during the follow up period were analyzed in relation to the TSI levels.
Results::
48 patients were included (35 female, 13 male). The mean age of the group was 11.3 + 4.1 years. 65% had positive TSI levels at the time of diagnosis, and 52.1% developed GO during the follow up period (19.9 + 18.3 months). A significant association between the initial TSI levels and GO was found (Chi-square=6.99, p< 0.01). The most frequent ocular findings were mild proptosis (43.8%), exposure keratitis (4.2%), lid lag (2.1%), and motility deficits (2.1%).
Conclusions::
There is an association between the initial levels of TSI and the development of GO in patients with GD. Even though, the ocular findings in children may be present, they are usually mild and in general don’t need surgical treatment.
Keywords: clinical (human) or epidemiologic studies: risk factor assessment • clinical laboratory testing