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Bin Sun, Zhaoxia Zhang, Chunli Bao, Shengbin Li; 99Tcm-Octreotide Scintigraphy in Evaluation of Thyroid-Associated Ophthalmopathy in Pediatric Patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5161. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
As an autoimmune inflammatory disorder, thyroid associated ophthalmopathy (TAO) is less severe and less frequent in children than in adult. Neither the NOSPECT classification nor the clinical activity score (CAS) is validated in evaluation of TAO in pediatric patient. In this study, we aimed to determine the clinical characteristics and evaluate octreotide scintigraphy in pediatric patient with TAO.
This retrospective study comprised 20 pediatric patients (10.851.42 years) with TAO, 25 adult TAO patients, and 30 healthy subjects. All cases were diagnosed in First Hospital of Shanxi Medical University from 10/2008 through 07/2015. Data were obtained from a follow-up survey.
The 20 pediatric patient with TAO were identified, including 15 girls (75%) and 5 boys (25%). At the time of initial diagnosis of TAO, 18 patients (90%) were hyperthyroid, and 2 patients (10%) were euthyroid. The mean course of thyroid disorder was 12.48 months (range, 10 days to 36 months), and the mean course of TAO was 10.40 months (range, 1 to 36). 18 patients (90%) had bilateral TAO. Main symptoms of pediatric patients with TAO were eyelid retraction (85%) and exophthalmos (95%). Of the 13 pediatric patients studied with orbital B-scan ultrasonography, 10 (76.9%) had enlarged extraocular muscles; but only 2 exhibited eye movement restriction. None had optic neurophathy. 99Tcm-octreotide scintigraphy was positive in pediatric patients with TAO (95%) with elevated uptake ration (UR) (P<0.05). There was no significant difference between the pediatric patients with TAO and the adult patients (P>0.05). The pediatric patients with hyperthyroidism were treated with antithyroid drugs. For TAO, a wait-and-see policy were recommended. The 99Tcm-octreotide UR in pediatric TAO was decreased significantly when the symptoms alleviated 3 months later (P<0.05).
The clinical manifestations of pediatric TAO were usually mild and self-limited. Eyelid retraction and exophthalmos were the most common features and bilateral involvement. 99Tcm-octreotide scintigraphy played a critical role in evaluation of pediatric TAO.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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