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Leslie Hyman, Robert Penne, Danielle Fujino, Deepak Ramesh, Qiang Zhang, Scott Kelly, Flora Lum, Sukhminder Singh; Prevalence and Associated Factors for Thyroid Eye Disease (TED) in the AAO IRIS® Registry. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5425.
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© ARVO (1962-2015); The Authors (2016-present)
Thyroid eye disease (TED) studies, to date, have focused on select populations . The AAO IRIS® Registry allows estimates of TED prevalence and associated factors in a large population of ophthalmology patients in the United States.
Individuals in the IRIS Registry (2013-2018) ≥18 years of age were included. TED was identified by ICD (ICD-9: 242.00, ICD-10: E05.00). Prevalence was estimated overall, by age (categorically), sex, ethnicity (Asian [A], White [W], Black [B], Hispanic [H]), Other[O]), geographic region (Midwest[MW], Northeast[NE], South[S], West[W]), and smoking status (never, former, current). Prevalence rate differences were compared using χ2 tests. Adjusted odds ratios (OR) and 95% Confidence Intervals (CIs) were estimated using multivariable logistic regression.
82,663 cases of TED were identified. Overall prevalence was 0.16% (16/100,000), and varied by age (p<0.0001): lowest rates for ages ≤35 years (y) (0.11%), highest for ages 35-59 y (0.23%), with consistent prevalence within 5-year groupings, decreasing to 0.13% in persons> 60y. Prevalence was higher in females (0.22%) vs males (0.07%) (p<0.0001), varied by ethnicity (p=0.0001) (lowest in H [0.10%], highest in AA [0.23%], intermediate rates for A[0.14%], W[0.18%] and O[0.16%] and by geographic region (highest in the MW (0.19%) vs other regions (0.14-0.15%) (p<0.0001). Prevalence was higher in current smokers (0.26%) vs former (0.19%) or never smokers (0.15%) (p<0.0001). In a multivariable model examining associations between TED and the above factors as covariates, age (18-35y (reference), 36-60y: OR (95% CI) 1.9 (1.9, 2.0), >60y: 1.0 (1.0,1.1), female sex: 3.2 (3.2,3.3), ethnicity: W (ref), B: 1.2 (1.2,1.3), H: 0.5 (0.5,0.6), A: 0.8 (0.8,0.9), O: 0.9 (0.83, 0.96), smoking status (never (ref), former: 1.48 (1.4,1.5), current 1.77: (1.7,1.8)) and geographic region (S (ref), MW: 1.3 (1.3,1.4), NE: 1.1(1.1, 1.1), W: 1.1 (1.1, 1.2)) were significantly associated with TED.
This is the first study to provide data on TED prevalence and associated factors from a large national clinical population. Associations with female sex and current smoking are consistent with prior reports. The consistent higher prevalence across ages 35 – 59 years vs older/ younger age groups, higher prevalence in AAs, and geographic variation are new observations that offer insights for further investigation.
This is a 2020 ARVO Annual Meeting abstract.
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