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Valerie Chen, Patrick Frias, Hee Joon Kim; Pediatric thyroid eye disease: A 5-year review of clinical presentation, management, and outcomes at a single tertiary care center. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5163.
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To summarize the clinical findings, treatments, outcomes, and complications for pediatric patients with thyroid eye disease in a single tertiary care center
A retrospective chart review was performed for pediatric patients (<18 years old) treated for thyroid eye disease at Emory University Hospital and Children's Healthcare of Atlanta between January 1, 2010 and December 31, 2015. Charts were reviewed for demographics, medical history, presenting symptoms, clinical exam findings, laboratory results, imaging studies, treatments, and outcomes.
Twenty five pediatric patients with thyroid eye disease met criteria and were included in the study. Average age at diagnosis was 12.8 years (range 5-18 years). There was a heavy female predominance (92%). Twenty three patients (92%) were hyperthyroid on presentation. Prescribed medications included methimazole (96%), beta blockers (60%), and levothyroxine (60%). Other treatments included radioactive iodine (20%) and thryoidectomy (40%). The averate presenting visual acuity was logMar 0.055 (20/23 equivalent). There was abnormal motility on presentation in 8%. Upper lid retraction was present in 48% and lower lid retraction in 44%. Surgical decompression was performed in 1 (4%) patient. Lid retraction repair was performed in 2 (8%). No patient required strabismus surgery.
While thyroid eye disease tends to be more mild in the pediatric population and can often regress after treatment of thryoid dysfunction, surgical intervention may still be necessary to prevent complications and sight-threatening sequelae.
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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