June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Thyroid Eye Disease: A USA (Wills Eye Hospital) and India (LV Prasad) Comparison
Author Affiliations & Notes
  • Leslie Hyman
    Vickie and Jack Farber Vision Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
    Ophthalmology, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
  • Sathyadeepak Ramesh
    Oculoplastic and Orbital Surgery, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
    Center for Eye and Facial Plastic Surgery, Somerset, New Jersey, United States
  • Alison Watson
    Oculoplastic and Orbital Surgery, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • James Sharpe
    Vickie and Jack Farber Vision Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Anthony Vipin Das
    L V Prasad Eye Institute, India
  • Qiang (Ed) Zhang
    Vickie and Jack Farber Vision Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Mark Moster
    Neuro-Ophthalmology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Kieran Alessi
    Vickie and Jack Farber Vision Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Ellen Peskin
    Vickie and Jack Farber Vision Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Milind Neelkanth Naik
    Ophthalmic Plastic Surgery Service, L V Prasad Eye Institute, India
  • Footnotes
    Commercial Relationships   Leslie Hyman None; Sathyadeepak Ramesh Horizon Therapeutics, Code C (Consultant/Contractor); Alison Watson Horizon Therapeutics, Code C (Consultant/Contractor); James Sharpe None; Anthony Vipin Das None; Qiang Zhang None; Mark Moster Gensight Biologics, Code C (Consultant/Contractor), Viridian, Code C (Consultant/Contractor), Gensight Biologics, Code F (Financial Support), Sanofi Genzyme, Code R (Recipient); Kieran Alessi None; Ellen Peskin None; Milind Naik None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4003 – A0345. doi:
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      Leslie Hyman, Sathyadeepak Ramesh, Alison Watson, James Sharpe, Anthony Vipin Das, Qiang (Ed) Zhang, Mark Moster, Kieran Alessi, Ellen Peskin, Milind Neelkanth Naik; Thyroid Eye Disease: A USA (Wills Eye Hospital) and India (LV Prasad) Comparison. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4003 – A0345.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Thyroid eye disease (TED) is an autoimmune process with possible vision-threatening manifestations. Little is known about the variability of TED characteristics in different ethnic populations. This pilot study aimed to compare demographic and clinical characteristics of TED and its impact on quality of life among patients at LV Prasad (LVP), Hyderabad, India and Wills Eye Hospital (WEH), Philadelphia, USA and to explore feasibility for a larger longitudinal study.

Methods : TED patients ages ≥18yrs, with active disease (onset ≤18m or Clinical Activity Score (CAS) ≥4) were recruited between 3/2021 -10/2021 at each center. Demographic, medical history, smoking and quality of life data were collected, a comprehensive orbital and ocular evaluation performed, and external eye photographs taken using standard protocols. Data between the WEH and LVP groups were compared using χ2, Fisher's exact tests, t-tests, or Wilcoxon rank sum tests.

Results : Sixty patients (30/center) were enrolled. WEH and LVP patients did not differ significantly by age (50.7 yrs. vs 45.6 yrs., respectively; p=0.13) or smoking status: % smokers (23% vs 13%; p=0.51). Significant differences between groups were seen by sex (% female: WEH: 86.7% vs LVP: 46.7%; p<0.001) and associated thyroid state (% Graves Disease: WEH: 93% vs LVP: 3%: p<0.0001; and % history of hyperthyroidism: WEH: 80% vs LVP: 50%: p=0.01). Clinical features (corneal and optic nerve status, exophthalmometry), quality of life measures and symptoms of retrobulbar ache and pain with eye movements did not differ significantly between groups (all p> 0.05). However, all (30/30) WEH patients vs. 11% of LVP patients exhibited CAS ≥4. WEH patients also were more symptomatic, e.g. higher CAS scores (mean (SD) 4.17 (1.7) for WEH vs 1.8 (1.7) for LVP), had higher frequencies of chemosis and conjunctival injection and more reported subjective symptoms of ocular irritation and blurry vision (all p values <0.0001).

Conclusions : Significant differences observed in the WEH and LVP patients by sex, underlying thyroid state, clinical activity, signs and some symptoms raise questions about possible variations in underlying pathogenesis, clinical disease expression or other unknown factors that may influence TED and its course in different ethnic populations. A larger study with longitudinal follow up is needed to further elucidate these novel observations.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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