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van Munster EPJ, van Nispen RMA, Hoogland J, van der Aa HPA. Feasibility and potential effectiveness of the IdentifEYE training programmes to address mental health problems in adults with vision impairment. Ophthalmic Physiol Opt 2024; 44:399-412. [PMID: 38063259 DOI: 10.1111/opo.13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE Two training programmes about depression and anxiety in adults with vision impairment were developed to support eye care practitioners (ECPs) and low vision service (LVS) workers in identifying and discussing mental health problems. The purpose of this study was to evaluate the training programmes' potential effectiveness and feasibility. METHODS The training programmes were offered to ECPs (n = 9) and LVS workers (n = 17). All participants completed surveys pre-, mid- and post-training, and at a 4 week follow-up about the training programmes' content, effectiveness, feasibility and implementation. The Kirkpatrick model was used as a theoretical framework; linear mixed models were used to determine the potential effectiveness, and outcomes were explored during three focus group meetings. RESULTS Expectations were met in the majority of the participants (84.6%). Post-training, both ECPs and LVS workers reported increased confidence (β = 3.67, confidence interval (CI): 0.53-6.80; β = 4.35, CI: 1.57 to 7.14, respectively) and less barriers (β = -3.67, CI: -6.45 to -0.89; β = -1.82, CI: -4.56 to 0.91). Mental health problems were more likely addressed in both the groups (ECP β = 2.22, CI: -0.17 to 4.62; LVS β = 4.18, CI: 2.67 to 5.68), but these effects did not last in ECPs (β = -3.22, CI: -7.37 to 0.92). Variations of these learning effects between individual participants were found within both the groups, and LVS workers indicated a need to focus on their own profession. Participants provided information on how to improve the training programmes' feasibility, effectiveness and implementation. CONCLUSION The training programmes seemed feasible and potentially effective. Transfer of the lessons learned into daily practice could be enhanced by, for example, specifying the training programmes for healthcare providers with the same profession, introducing microlearning and incorporating mental health management into organisation policies.
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Affiliation(s)
- Edine P J van Munster
- Ophthalmology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, the Netherlands
- Robert Coppes Foundation, Expertise Innovation and Knowledge, Vught, the Netherlands
| | - Ruth M A van Nispen
- Ophthalmology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, the Netherlands
| | - Jeroen Hoogland
- Epidemiology & Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hilde P A van der Aa
- Ophthalmology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, the Netherlands
- Robert Coppes Foundation, Expertise Innovation and Knowledge, Vught, the Netherlands
- The Lighthouse Guild NYC, New York, New York, USA
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Jiang W, Liu J, Zhou J, Wu Q, Pu X, Chen H, Xu X, Wu F, Hu H. Altered dynamic brain activity and functional connectivity in thyroid-associated ophthalmopathy. Hum Brain Mapp 2023; 44:5346-5356. [PMID: 37515416 PMCID: PMC10543102 DOI: 10.1002/hbm.26437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/18/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Although previous neuroimaging evidence has confirmed the brain functional disturbances in thyroid-associated ophthalmopathy (TAO), the dynamic characteristics of brain activity and functional connectivity (FC) in TAO were rarely concerned. The present study aims to investigate the alterations of temporal variability of brain activity and FC in TAO using resting-state functional magnetic resonance imaging (rs-fMRI). Forty-seven TAO patients and 30 age-, gender-, education-, and handedness-matched healthy controls (HCs) were enrolled and underwent rs-fMRI scanning. The dynamic amplitude of low-frequency fluctuation (dALFF) was first calculated using a sliding window approach to characterize the temporal variability of brain activity. Based on the dALFF results, seed-based dynamic functional connectivity (dFC) analysis was performed to identify the temporal variability of efficient communication between brain regions in TAO. Additionally, correlations between dALFF and dFC and the clinical indicators were analyzed. Compared with HCs, TAO patients displayed decreased dALFF in the left superior occipital gyrus (SOG) and cuneus (CUN), while showing increased dALFF in the left triangular part of inferior frontal gyrus (IFGtriang), insula (INS), orbital part of inferior frontal gyrus (ORBinf), superior temporal gyrus (STG) and temporal pole of superior temporal gyrus (TPOsup). Furthermore, TAO patients exhibited decreased dFC between the left STG and the right middle occipital gyrus (MOG), as well as decreased dFC between the left TPOsup and the right calcarine fissure and surrounding cortex (CAL) and MOG. Correlation analyses showed that the altered dALFF in the left SOG/CUN was positively related to visual acuity (r = .409, p = .004), as well as the score of QoL for visual functioning (r = .375, p = .009). TAO patients developed abnormal temporal variability of brain activity in areas related to vision, emotion, and cognition, as well as reduced temporal variability of FC associated with vision deficits. These findings provided additional insights into the neurobiological mechanisms of TAO.
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Affiliation(s)
- Wen‐Hao Jiang
- Department of RadiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Jun Liu
- Department of RadiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Jiang Zhou
- Department of RadiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Qian Wu
- Department of RadiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Xiong‐Ying Pu
- Department of RadiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Huan‐Huan Chen
- Department of EndocrinologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Xiao‐Quan Xu
- Department of RadiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Fei‐Yun Wu
- Department of RadiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Hao Hu
- Department of RadiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
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Lindo A, Breikert A, Lakwijk P, Lundberg C, Lunner K, Johansson B, Filipsson Nyström H. Patient needs and care: moves toward person-centered care for Graves' disease in Sweden. Eur Thyroid J 2023; 12:e230010. [PMID: 36912797 PMCID: PMC10160562 DOI: 10.1530/etj-23-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 03/13/2023] [Indexed: 03/14/2023] Open
Abstract
Patients with Graves' disease (GD) not only need appropriate medical care, but they also need to be cared for. The aim of this review is to examine the literature on GD patient needs, expectations, perceptions, and quality of life. We will also present methods for patient care, define gaps in knowledge, and suggest factors that can be introduced into the regular care of GD patients. Patient information, teamwork with thyroid/contact nurses, education of personnel and patients, quality of life measurements, and the formation of a rehabilitation program have enough evidence to be implemented into regular care. However, visualizing patient needs through person-centered care requires further evaluation in GD patients before being implemented in routine care. We conclude that considerable improvement in nursing can be achieved in relation to GD.
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Affiliation(s)
- Agneta Lindo
- Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
| | - Anne Breikert
- The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
- Department of Endocrinology and Diabetes, Örebro University Hospital, Örebro, Sweden
| | - Peter Lakwijk
- The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
- Thyroid Federation International, Kungsbacka, Sweden
| | - Christin Lundberg
- The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
- Swedish Thyroid Association, Stockholm, Sweden
| | - Katarina Lunner
- The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
- Swedish Thyroid Association, Stockholm, Sweden
| | - Birgitta Johansson
- Institute of Neuroscience and Physiology Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Helena Filipsson Nyström
- Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- The National Task Force in Hyperthyroidism, Swedish National System for Knowledge-Driven Management, Umeå, Sweden
- Sweden and Wallenberg Center for Molecular and Translational Medicine, Västra Götaland Region, Göteborg, Sweden
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Takahashi Y, Vaidya A. Secondary Effects of Orbital Decompression in Thyroid Eye Disease: A Review. Semin Ophthalmol 2023:1-10. [PMID: 36631972 DOI: 10.1080/08820538.2023.2166354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Orbital decompression is mainly performed in thyroid eye disease to reduce proptosis and retrobulbar pressure, to improve venous congestion, and to relieve optic nerve compression. Secondary effects of orbital decompression are also occasionally encountered. The aim of this study was to review the secondary effects of orbital decompression. METHODS This is a comprehensive literature review that summarizes the secondary effects of orbital decompression. RESULTS Decreased intraocular pressure, inter-pupillary distance, and eyelid pressure, and improvement of eyelid retraction, lateral flare, orbital discomfort, and psychosocial condition after orbital decompression are favorable changes for patients. In contrast, refractive changes in some patients and decreased Bell's phenomenon and nasal function worsen patients' condition. CONCLUSION These favorable changes may reduce the patients' burden for treatment of thyroid eye disease. In contrast, as some of the adverse effects significantly worsen the patients' disease condition, we should carefully monitor these changes.
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Affiliation(s)
- Yasuhiro Takahashi
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Aichi, Japan
| | - Aric Vaidya
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Aichi, Japan.,Department of Oculoplastic, Orbital & Lacrimal Surgery, Kirtipur Eye Hospital, Kathmandu, Nepal
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Chen W, Hu H, Chen HH, Liu H, Wu Q, Chen L, Zhou J, Jiang WH, Xu XQ, Wu FY. Altered neurovascular coupling in thyroid-associated ophthalmopathy: A combined resting-state fMRI and arterial spin labeling study. J Neurosci Res 2023; 101:34-47. [PMID: 36134557 DOI: 10.1002/jnr.25126] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/30/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022]
Abstract
Besides the well-documented ophthalmic manifestations, thyroid-associated ophthalmopathy (TAO) is believed to be related to emotional and psychological abnormalities. Given the previous neuroimaging evidence, we hypothesized that TAO patients would have altered neurovascular coupling associated with clinical-psychiatric disturbances. This study was to investigate neurovascular coupling changes in TAO by combining resting-state functional magnetic resonance imaging (rs-fMRI) and arterial spin labeling (ASL) techniques. Amplitude of low-frequency fluctuation (ALFF) was calculated from rs-fMRI, and cerebral blood flow (CBF) was computed from ASL in 37 TAO patients and 21 healthy controls (HCs). Global neurovascular coupling was assessed by across-voxel CBF-ALFF correlation, and regional neurovascular coupling was evaluated by CBF/ALFF ratio. Auxiliary analyses were performed using fractional ALFF (fALFF) and regional homogeneity (ReHo) as rs-fMRI measures. Compared with HCs, TAO patients showed significantly reduced global CBF-ALFF coupling. Moreover, TAO patients exhibited decreased CBF/ALFF ratio in the left lingual gyrus (LG)/fusiform gyrus (FFG), and increased CBF/ALFF ratio in the bilateral precuneus (PCu). In TAOs, CBF/ALFF ratio in the left LG/FFG was positively correlated with visual acuity, while CBF/ALFF ratio in the bilateral PCu was negatively correlated with Montreal Cognitive Assessment score. The auxiliary analyses showed trends of reduced global neurovascular coupling (i.e., CBF-fALFF correlation and CBF-ReHo correlation), as well as significant altered regional neurovascular coupling (i.e., CBF/fALFF ratio and CBF/ReHo ratio) in several brain regions. These findings indicated that TAO patients had altered neurovascular coupling in the visual and higher-order cognitive cortices. The neurovascular decoupling might be a possible neuropathological mechanism of TAO.
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Affiliation(s)
- Wen Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huan-Huan Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qian Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lu Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wen-Hao Jiang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Chen W, Hu H, Wu Q, Chen L, Zhou J, Chen HH, Xu XQ, Wu FY. Altered Static and Dynamic Interhemispheric Resting-State Functional Connectivity in Patients With Thyroid-Associated Ophthalmopathy. Front Neurosci 2021; 15:799916. [PMID: 34938158 PMCID: PMC8685321 DOI: 10.3389/fnins.2021.799916] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: Thyroid-associated ophthalmopathy (TAO) is a debilitating and sight-threatening autoimmune disease that severely impairs patients' quality of life. Besides the most common ophthalmic manifestations, the emotional and psychiatric disturbances are also usually observed in clinical settings. This study was to investigate the interhemispheric functional connectivity alterations in TAO patients using resting-state functional magnetic resonance imaging (rs-fMRI). Methods: Twenty-eight TAO patients and 22 healthy controls (HCs) underwent rs-fMRI scans. Static and dynamic voxel-mirrored homotopic connectivity (VMHC) values were calculated and compared between the two groups. A linear support vector machine (SVM) classifier was used to examine the performance of static and dynamic VMHC differences in distinguishing TAOs from HCs. Results: Compared with HCs, TAOs showed decreased static VMHC in lingual gyrus (LG)/calcarine (CAL), middle occipital gyrus, postcentral gyrus, superior parietal lobule, inferior parietal lobule, and precuneus. Meanwhile, TAOs demonstrated increased dynamic VMHC in orbitofrontal cortex (OFC). In TAOs, static VMHC in LG/CAL was positively correlated with visual acuity (r = 0.412, P = 0.036), whilst dynamic VMHC in OFC was positively correlated with Hamilton Anxiety Rating Scale (HARS) score (r = 0.397, P = 0.044) and Hamilton Depression Rating Scale (HDRS) score (r = 0.401, P = 0.042). The SVM model showed good performance in distinguishing TAOs from HCs (area under the curve, 0.971; average accuracy, 94%). Conclusion: TAO patients had altered static and dynamic VMHC in the occipital, parietal, and orbitofrontal areas, which could serve as neuroimaging prediction markers of TAO.
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Affiliation(s)
- Wen Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qian Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lu Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huan-Huan Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Cockerham KP, Padnick-Silver L, Stuertz N, Francis-Sedlak M, Holt RJ. Quality of Life in Patients with Chronic Thyroid Eye Disease in the United States. Ophthalmol Ther 2021; 10:975-987. [PMID: 34478126 PMCID: PMC8589903 DOI: 10.1007/s40123-021-00385-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/09/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Thyroid eye disease (TED) is an autoimmune condition producing ocular pain, dysmotility, and ocular structure and function changes. As disease activity changes, redness, swelling, and pain can improve, but eye comfort, appearance, and motility alterations often persist. There are limited data on chronic TED patient-reported outcomes. This study examined chronic US TED patient-reported symptoms and quality of life (QOL). METHODS Existing data from an online survey regarding chronic TED signs/symptoms and patient QOL were retrospectively examined. The Graves' Ophthalmopathy QOL instrument (GO-QOL; 0-100, 100 = highest QOL) evaluated overall, appearance, and vision-related QOL. Influencing factors were examined by stratifying patients into low (overall QOL ≤ 50), moderate (> 50 and < 75), and high (≥ 75) QOL categories. RESULTS One hundred patients (47 women, 81 Caucasian, 45.2 ± 7.6 years) were included. The duration of inactive TED was 3.0 ± 4.6 years and total duration of TED was 5.8 ± 5.9 years. Patients reported an average of 20 doctor visits/year and high prevalence of anxiety (34%) and depression (28%). Prior TED treatments for the polled population included systemic corticosteroids during active TED (25%), orbital radiation (5%), and surgery (25%). The overall GO-QOL score was 60.5 ± 21.8 (vision-related: 58.6 ± 24.0, appearance-related: 62.3 ± 25.1). Patients with low QOL more frequently reported hypothyroidism, anxiety, and a larger number of chronic TED signs/symptoms (average: 4.2). Compared to high QOL patients, low QOL patients had more pain (39% vs. 13%), blurry vision (30% vs. 17%), and diplopia (27% vs. 3%, all p ≤ 0.025). Additionally, the low QOL group more often had TED-specific surgical history (45% vs. 10%, p = 0.002), more often reported disability/unemployment (21% vs. 3%, p = 0.055), and had a higher number of doctor visits (40 vs. 5 visits/person/year, p < 0.001). CONCLUSION TED severely impacts patient QOL, despite becoming stable and chronic. Patients reported vision and appearance impairment and psychosocial impact long after acute TED had subsided.
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Affiliation(s)
- Kimberly P. Cockerham
- Central Valley Eye Medical Group, 36 W Yokuts Avenue, Suite 2, Stockton, CA 95207 USA
- Department of Ophthalmology, Stanford School of Medicine, 2454 Watson Court, Palo Alto, CA 94303 USA
| | | | - Noel Stuertz
- Horizon Therapeutics plc, 1 Horizon Way, Deerfield, IL 60015 USA
| | | | - Robert J. Holt
- Horizon Therapeutics plc, 1 Horizon Way, Deerfield, IL 60015 USA
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Ong AA, DeVictor S, Vincent AG, Namin AW, Wang W, Ducic Y. Bony Orbital Surgery for Graves' Ophthalmopathy. Facial Plast Surg 2021; 37:692-697. [PMID: 34500489 DOI: 10.1055/s-0041-1735638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The majority of Graves' ophthalmopathy, or thyroid eye disease, can be managed medically; however, in refractory or severe cases, surgical intervention with orbital decompression may be necessary. The majority of the published literature is retrospective in nature, and there is no standardized approach to orbital decompression. The purpose of this review is to evaluate the various surgical approaches and techniques for orbital decompression. Outcomes are ultimately dependent on individual patient factors, surgical approach, and surgeon experience.
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Affiliation(s)
- Adrian A Ong
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
| | - Samuel DeVictor
- Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York
| | - Aurora G Vincent
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
| | - Arya W Namin
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
| | - Weitao Wang
- Department of Otolaryngology-Head and Neck Surgery, University of Rochester, Rochester, New York
| | - Yadranko Ducic
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
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Chen W, Wu Q, Chen L, Zhou J, Chen HH, Xu XQ, Hu H, Wu FY. Disrupted Spontaneous Neural Activity in Patients With Thyroid-Associated Ophthalmopathy: A Resting-State fMRI Study Using Amplitude of Low-Frequency Fluctuation. Front Hum Neurosci 2021; 15:676967. [PMID: 34177495 PMCID: PMC8226248 DOI: 10.3389/fnhum.2021.676967] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/03/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The purpose of the study was to investigate the brain functional alteration in patients with thyroid-associated ophthalmopathy (TAO) by evaluating the spontaneous neural activity changes using resting-state functional magnetic resonance imaging (rs-fMRI) with the amplitude of low-frequency fluctuation (ALFF) method. MATERIALS AND METHODS The rs-fMRI data of 30 TAO patients (15 active and 15 inactive) and 15 healthy controls (HCs) were included for analyses. The ALFF values were calculated and compared among groups. Correlations between ALFF values and clinical metrics were assessed. RESULTS Compared with HCs, active TAOs showed significantly decreased ALFF values in the left middle occipital gyrus, superior occipital gyrus, and cuneus. Compared with inactive TAOs, active TAOs showed significantly increased ALFF values in the bilateral precuneus. Additionally, inactive TAOs showed significantly decreased ALFF values in the left middle occipital gyrus, superior occipital gyrus, cuneus, and bilateral precuneus than HCs. The ALFF value in the right precuneus of TAOs was positively correlated with clinical activity score (r = 0.583, P < 0.001) and Mini-Mental State Examination (MMSE) score (r = 0.377, P = 0.040), and negatively correlated with disease duration (r = -0.382, P = 0.037). Moreover, the ALFF value in the left middle occipital gyrus of TAOs was positively correlated with visual acuity (r = 0.441, P = 0.015). CONCLUSION TAO patients had altered spontaneous brain activities in the left occipital lobe and bilateral precuneus. The neuropsychological aspect of the disease should be noticed during clinical diagnosis and treatment.
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Affiliation(s)
- Wen Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qian Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lu Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huan-Huan Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Luisa V, Riccardo T, Stefano P, Manlio G. Effectiveness of orbital decompression for endocrine orbitopathy and impact on quality of life: A retrospective study. J Craniomaxillofac Surg 2021; 49:867-874. [PMID: 34218976 DOI: 10.1016/j.jcms.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 02/11/2021] [Accepted: 03/11/2021] [Indexed: 11/25/2022] Open
Abstract
To evaluate the effectiveness of orbital decompression intervention in terms of variation of the exophthalmos and to highlight its association with changes in quality of life before and after surgery. Medical records of patients with moderate-severe GO who underwent orbital decompression surgery were retrospectively reviewed. Clinical parameters, including demographic characteristics, surgical technique, exophthalmos values, and QoL using the GO-QoL questionnaire were studied before and after orbital decompression and analyzed. Thirty patients were included in the study. Surgery was bilateral 26 patients and unilateral in 4 patients (56 operated orbits). Before surgery the average value of exophthalmometry was 24.96 (±2.68) mm. The questionnaires submitted for assessment of the quality of life (GO-QoL) yielded average values of 43.3 for the visual function (VF) and 44.03 for the appearance (AP). 20 patients (64.3%) underwent combined bone and fat decompression surgery, 9 underwent fat decompression, and 1 underwent bone decompression. After surgery, the average values of exophthalmometry were 21.8 (±2.34) mm, with an average reduction of 3.20 (±2.35) mm. (p < 0.0001) GO-QoL questionnaires administered after surgery showed a mean VF score of 76.73 (±26.75), and AP score of 73.71 (±21.89). (p < 0.001, paired t-test) Orbital decompressive surgery is not only effective on GO, but also on a long-term improvement in overall well-being, self-confidence and QoL.
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Affiliation(s)
- Valente Luisa
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities & Orbital Surgery - Reference Center for Rare Disease, Sant'Anna Hospital and University, Cona, Ferrara, Italy
| | - Tieghi Riccardo
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities & Orbital Surgery - Reference Center for Rare Disease, Sant'Anna Hospital and University, Cona, Ferrara, Italy.
| | | | - Galiè Manlio
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities & Orbital Surgery - Reference Center for Rare Disease, Sant'Anna Hospital and University, Cona, Ferrara, Italy
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Wu Q, Hu H, Chen W, Chen HH, Chen L, Zhou J, Liu H, Wu FY, Xu XQ. Disrupted Topological Organization of the Brain Structural Network in Patients With Thyroid-Associated Ophthalmopathy. Invest Ophthalmol Vis Sci 2021; 62:5. [PMID: 33821882 PMCID: PMC8039468 DOI: 10.1167/iovs.62.4.5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose Increasing evidence indicated that thyroid-associated ophthalmopathy (TAO) might be a neural related disease more than an ocular disease. In this study, we aimed to investigate the alterations of structural brain connectome in patients with TAO. Methods Twenty-seven patients with TAO and 27 well-matched healthy controls underwent diffusion tensor imaging. Graph theoretical analyses, including global (shortest path length, clustering coefficient, small-worldness, global efficiency, and local efficiency) and nodal (nodal betweenness, nodal degree, and nodal efficiency) topological properties and network-based statistics were performed to evaluate TAO-related changes in brain network pattern. Correlations were assessed between the network properties and clinical variables, including disease duration, visual acuity, neuropsychiatric measurements, and serum thyroid function indexes. Results Compared with healthy controls, patients with TAO exhibited preserved global network parameters but altered nodal properties. We found decreased nodal betweenness and nodal degree in right anterior cingulate and paracingulate gyri, decreased nodal degree and nodal efficiency in the right orbital part of middle frontal gyrus (ORBmid), whereas increased nodal degree and nodal efficiency in the left cuneus. Decrease of structural connectivity strength was found involving the right ORBmid, right putamen, left caudate nucleus, and left medial superior frontal gyrus. Significant correlations were also found between nodal properties and neuropsychological performances as well as visual acuity. Conclusions Patients with TAO developed disruption of structural brain network connectome. Disrupted topological organization of the brain structural network may be associated with the clinical-psychiatric dysfunction of patients with TAO.
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Affiliation(s)
- Qian Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wen Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huan-Huan Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lu Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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12
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Ugradar S, Wang Y, Mester T, Kahaly GJ, Douglas R. Improvement of asymmetric thyroid eye disease with teprotumumab. Br J Ophthalmol 2021; 106:755-759. [PMID: 33579690 PMCID: PMC9132868 DOI: 10.1136/bjophthalmol-2020-318314] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/29/2020] [Accepted: 01/07/2021] [Indexed: 11/28/2022]
Abstract
Purpose Teprotumumab, a specific blocking antibody to the insulin like growth factor 1 receptor, significantly reduced proptosis in patients with thyroid eye disease (TED) in recent clinical trials. Given its specificity, we expect it to demonstrate greater efficacy on the worse affected orbit, in patients with asymmetric TED. Herein, we investigate the differential impact of teprotumumab on the orbits of such patients. Methods In this pooled analysis of patients who were enrolled in the recent phase 2 (NCT01868997) and phase 3 (NCT03298867) trials, all patients with asymmetric TED (difference in exophthalmometry of ≥3 mm) were screened for eligibility. The primary outcomes of the trials, proptosis, diplopia and Clinical Activity Score (CAS) response, were evaluated in both orbits of patients who had received treatment or placebo, to examine the differential response from baseline to week 24. Results From a pooled group of 84 patients randomised to receive teprotumumab and 87 randomised to placebo, 10 (12%) and 12 (14%), respectively, met the inclusion criteria. The teprotumumab-treated patients demonstrated significant reductions in proptosis, CAS and diplopia in both orbits of each patient and this was not seen with placebo. The reduction in proptosis and CAS was significantly greater in the worse affected orbit, improving symmetry. In the placebo arm, while the mean CAS in the study eye reduced over time, proptosis and diplopia did not change in either orbit. Conclusion The findings in this study suggest the differential impact of teprotumumab on orbits that are clinically more affected by TED, suggesting that teprotumumab reduces asymmetry.
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Affiliation(s)
- Shoaib Ugradar
- Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, Los Angeles, California, USA
| | - Yao Wang
- Oculoplastics, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Tunde Mester
- Oculoplastics, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - George J Kahaly
- Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Raymond Douglas
- Ophthalmology, Cedars-Sinai Medical Center, Los Angeles, California, USA
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13
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Zloto O, Sagiv O, Priel A, Cukierman-Yaffe T, Tirosh A, Agmon-Levin N, Madgar S, Serlin T, Ben Simon G. Gender differences in clinical presentation and prognosis of thyroid eye disease. Eur J Ophthalmol 2020; 31:2717-2723. [PMID: 33158379 DOI: 10.1177/1120672120964112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the clinical differences in manifestation, treatment, and prognosis of thyroid-eye-disease (TED) between men and women. METHODS This is a longitudinal cohort study. Men and women, who diagnosed with TED and treated at a multidisciplinary TED clinic, were compared regarding differences in demographics, eye examination, disease activity, and quality of life evaluation. RESULTS TED was diagnosed in 132 patients during the study period, and they included 38 men (28.78%) and 94 women (71.21%). There were six men and 20 women with active disease (Clinical-Activity-Score (CAS) ⩾ 3) during the entire follow-up period (p < 0.01). The mean time from TED diagnosis to CAS ⩾ 3 was 4.50 years for men and 2.35 years for women (p = 0.05). There were no significant differences in mean total Graves' Orbitopathy-Quality-of-Life questionnaire (GO-QOL) score. However, mean GO-QOL subtotal score of external appearance of women was significantly lower compare to men in the first and last visit (p = 0.04, 0.03, respectively). CONCLUSION Active disease was more common in women and the time-from-diagnosis of TED to CAS ⩾ 3 was shorter among women. Moreover, the appearance QOL score of women was poorer. These findings should be taken into consideration when planning the timing of treatment and when choosing the best treatment for TED patients.
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Affiliation(s)
- Ofira Zloto
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Israel Sheba Medical Center, Tel-Hashomer, Israel
| | - Oded Sagiv
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Israel Sheba Medical Center, Tel-Hashomer, Israel
| | - Ayelet Priel
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Israel Sheba Medical Center, Tel-Hashomer, Israel
| | - Tali Cukierman-Yaffe
- Sackler Faculty of Medicine, Tel-Aviv University, Israel Sheba Medical Center, Tel-Hashomer, Israel.,Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel-Hashomer, Israel
| | - Amir Tirosh
- Sackler Faculty of Medicine, Tel-Aviv University, Israel Sheba Medical Center, Tel-Hashomer, Israel.,Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel-Hashomer, Israel
| | - Nancy Agmon-Levin
- Sackler Faculty of Medicine, Tel-Aviv University, Israel Sheba Medical Center, Tel-Hashomer, Israel.,Lupus Clinic, Clinical Immunology, Angioedema and Allergy Unit, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - Shiran Madgar
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Tal Serlin
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Guy Ben Simon
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Israel Sheba Medical Center, Tel-Hashomer, Israel
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14
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Cooper OAE, Taylor DJ, Crabb DP, Sim DA, McBain H. Psychological, social and everyday visual impact of diabetic macular oedema and diabetic retinopathy: a systematic review. Diabet Med 2020; 37:924-933. [PMID: 31479552 DOI: 10.1111/dme.14125] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 01/11/2023]
Abstract
AIMS To synthesize the evidence on the impact of diabetic retinopathy and diabetic macular oedema from the patient perspective. METHODS A systematic literature review was conducted using MEDLINE Complete, PsycINFO, EMBASE and AMED. We included articles investigating the impact of the condition on quality of life, symptoms, visual functioning, activities of daily living, well-being, social functioning, and financial status. The studies evaluated were observational, including cross-sectional, prospective cohort and retrospective cohort designs. Outcome data were extracted and synthesized. RESULTS Searches yielded 5114 publications. After screening, 85 studies were included, measuring the following outcomes: visual functioning (n=46); quality of life (n=22); well-being (n=16); functional status (n=5); work (n=4); and visual task performance (n=2). Diabetic retinopathy has a considerable impact on visual functioning and this is greater in people with greater disease severity. Diabetic retinopathy significantly limits activities including working, driving, walking and reading, and has the potential to have a negative impact on psychological well-being. CONCLUSIONS Diabetic retinopathy is associated with poor self-reported visual functioning, well-being, and health-related quality of life. Ability to perform basic everyday tasks appears to diminish with disease severity. Some studies suggest impaired mobility and problems with work, but there are gaps in this evidence.
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Affiliation(s)
- O A E Cooper
- School of Health Sciences, City, University of London, London, UK
| | - D J Taylor
- School of Health Sciences, City, University of London, London, UK
| | - D P Crabb
- School of Health Sciences, City, University of London, London, UK
| | - D A Sim
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - H McBain
- School of Health Sciences, City, University of London, London, UK
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15
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Cogliandro A, Barone M, Ciarrocchi S, Salzillo R, Moss T, Tambone V, Persichetti P. A systematic review on the Derriford Appearance Scale (DAS) questionnaire in surgical research. Eur J Plast Surg 2020; 43:795-808. [DOI: 10.1007/s00238-020-01660-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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16
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Lawes-Wickwar S, McBain H, Hirani SP, Hurt CS, Dunlop N, Solly D, Crampton B, Newman SP, Ezra DG. Which factors impact on quality of life for adults with blepharospasm and hemifacial spasm? Orbit 2020; 40:110-119. [PMID: 32116098 DOI: 10.1080/01676830.2020.1733028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Benign essential blepharospasm (BEB) and hemifacial spasm (HFS) are debilitating conditions causing spasms to the eyes and/or face and can significantly impact on quality of life (QoL). Initial research has highlighted potential factors impacting on QoL in BEB, but there remains a wealth of demographic, clinical, and psychosocial factors that may contribute to QoL but have not received attention. Methods: Cross-sectional baseline data were collected before a single-masked randomised controlled trial from 130 adults with BEB and HFS recruited from botulinum toxin clinics at Moorfields Eye Hospital, London. QoL was measured using the 24-item Craniocervical Dystonia Questionnaire (CDQ24), which provides a total score and five subscale scores relating to Stigma, Emotional state, Pain, Activities of daily living (ADL), and Social/family life. Treating clinicians provided clinical data. Hierarchical multiple regressions were performed on this baseline data to identify significant predictors of QoL. Results: ADL and Stigma were the areas most impacted upon whilst patients experienced better adjustment in relation to Pain, Social/family life, and Emotional state. CDQ24 Total scores were explained by the model (80% variance) and were significantly associated with appearance concerns, emotional representations, perceived negative consequences of the condition, mood, and dose of botulinum toxin. Conclusions: Patients with BEB and HFS report a detrimental impact on ADL and perceived stigma in relation to their condition. Predominantly, individual perceptions and mood are associated with QoL in this population, rather than demographic and clinical factors, signifying areas to target in the design of future healthcare services or interventions.
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Affiliation(s)
- Sadie Lawes-Wickwar
- Centre for Health Services Research, City, University of London , London, UK.,Moorfields Eye Hospital NHS Foundation Trust , London, UK
| | - Hayley McBain
- Centre for Health Services Research, City, University of London , London, UK
| | | | - Catherine S Hurt
- Centre for Health Services Research, City, University of London , London, UK
| | - Nicola Dunlop
- Moorfields Eye Hospital NHS Foundation Trust , London, UK
| | - Dianne Solly
- Moorfields Eye Hospital NHS Foundation Trust , London, UK
| | | | - Stanton P Newman
- Centre for Health Services Research, City, University of London , London, UK
| | - Daniel G Ezra
- Moorfields Eye Hospital NHS Foundation Trust , London, UK
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17
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de-Arriba-Palomero P, Sales-Sanz M, Fuentemilla E, Won-Kim HR, de-Arriba-Palomero F, Muñoz-Negrete FJ. Effectiveness of oral counselling for smoke cessation in Graves orbitopathy patients. Arch Soc Esp Oftalmol (Engl Ed) 2019; 94:323-330. [PMID: 31036428 DOI: 10.1016/j.oftal.2019.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/27/2019] [Accepted: 03/13/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Smoking is an important risk factor for Graves orbitopathy (GO) and it is modifiable. The advice to stop smoking has been included in all the clinical practice guidelines of GO. However, the effectiveness of this practice remains unknown. The purpose of this study is to assess the change in the smoking habit in patients affected with GO after an oral counselling for smoking cessation. MATERIAL AND METHODS A retrospective cohort of GO patients was studied. The patients received a significant oral counsel during the first consultation with the ophthalmologist. 33 GO patients were explored in the ophthalmology clinic during 2013 and 2014 and the study was done throughout a telephone questionnaire in 2015. The main outcome was the number of cigarettes smoked daily before and after consultation with the endocrinologist and the ophthalmologist. Other medical and socioeconomic factors were recorded. RESULTS The mean number of cigarettes that were smoked was 13.6 (SD 9.66) and 6.3 (SD 7.73) before and after the consultation done at the ophthalmology office (T-test paired, P=0.0006). 42.42% achieved smoking cessation and 30.3% decreased their smoking habit. Patients who stopped smoking suffered usually from active and severe GO, had more stable jobs and received greater support from their relatives and friends. CONCLUSION A firm and strong oral counsel held for smoke cessation was effective in GO patients. This disease deeply affects patients' quality of life, making them more prone to change their habits.
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Affiliation(s)
- P de-Arriba-Palomero
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España.
| | - M Sales-Sanz
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España
| | - E Fuentemilla
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España
| | - H R Won-Kim
- Servicio de Oftalmología, Hospital Universitario La Princesa, Madrid, España
| | - F de-Arriba-Palomero
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España
| | - F J Muñoz-Negrete
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España; Universidad de Alcalá, Campus Universitario, Alcalá de Henares (Madrid), España
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18
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Massey CJ, Hink E, Kingdom TT. Endoscopic Orbital Decompression for Thyroid Eye Disease. Curr Otorhinolaryngol Rep 2019; 7:147-52. [DOI: 10.1007/s40136-019-00233-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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19
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Bruscolini A, Sacchetti M, La Cava M, Nebbioso M, Iannitelli A, Quartini A, Lambiase A, Ralli M, de Virgilio A, Greco A. Quality of life and neuropsychiatric disorders in patients with Graves' Orbitopathy: Current concepts. Autoimmun Rev 2018; 17:639-643. [DOI: 10.1016/j.autrev.2017.12.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 12/29/2017] [Indexed: 01/17/2023]
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20
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Wickwar S, McBain H, Edmunds MR, Ezra DG, Rose GE, Newman SP. Patients’ expectations for the functional and psychosocial outcomes of orbital decompression surgery for thyroid eye disease: a qualitative study. PSYCHOL HEALTH MED 2017; 23:475-484. [DOI: 10.1080/13548506.2017.1356930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sadie Wickwar
- School of Health Sciences, City, University of London, London, UK
- Moorfields Eye Hospital, London, UK
| | - Hayley McBain
- School of Health Sciences, City, University of London, London, UK
- East London NHS Foundation Trust, London, UK
| | - Matthew R. Edmunds
- Academic Unit of Ophthalmology, University of Birmingham, Birmingham, UK
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21
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Woo YJ, Yoon JS. Changes in pupillary distance after fat versus bony orbital decompression in Graves’ orbitopathy. Can J Ophthalmol 2017; 52:186-191. [DOI: 10.1016/j.jcjo.2016.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 06/13/2016] [Accepted: 08/15/2016] [Indexed: 11/28/2022]
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Abstract
Although most cases of thyroid eye disease (TED) can be managed medically, some refractory or severe cases are treated surgically with orbital decompression. Due to a lack of randomized controlled trials comparing surgical techniques for orbital decompression, none have been deemed superior. Thus, each case of TED is managed based on patient characteristics and surgeon experience. Surgical considerations include the extent of bony wall removal, the surgical approach, the choice of incision, and the use of fat decompression. Outcomes vary based on surgical indications and techniques; hence, vision can improve or worsen after the surgery.
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Affiliation(s)
- Tara L Braun
- Division of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | | | - Kevin T Jubbal
- Division of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Adam C Weber
- Division of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Douglas P Marx
- Division of Ophthalmology, Baylor College of Medicine, Houston, Texas
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23
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Delfino LC, Zunino A, Sapia V, Croome MDCS, Ilera V, Gauna AT. Related quality of life questionnaire specific to dysthyroid ophthalmopathy evaluated in a population of patients with Graves' disease. Arch Endocrinol Metab 2017; 61:374-381. [PMID: 28225858 PMCID: PMC10118924 DOI: 10.1590/2359-3997000000252] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 10/18/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study was to measure quality of life (QOL) impairment in individuals currently suffering from Graves' ophthalmopathy (GO) and to determine the correlation of GO-specific QOL scores with disease severity and activity. SUBJECTS AND METHODS Seventy three GO-specific QOL surveys were prospectively analysed and compared with GO status. The GO-specific QOL survey was translated into Spanish and applied to Argentine patients with Graves' disease (GD). Results were compared with presence or absence of GO, Clinical Activity Score (CAS), severity score, age, gender and thyroid function. RESULTS Fifty-six patients answered the survey and underwent complete ophthalmic evaluation, 15 did not have GO and were considered to be a control group. Appearance QOL score for patients with GO (53 ± 31.4) was lower than the control group (88.3 ± 17) (p < 0,000), no difference was observed in functional QOL score. There was a negative correlation between GO severity and both functional (r = -0.575; p < 0.000) and appearance QOL (r = -0.577; p < 0.000). Functional QOL differed between patients with active GO vs control group (p = 0.043). Patients with active and inactive GO had lower appearance QOL scores than control group (p < 0.000, p < 0.001 respectively). CONCLUSIONS GO has significant impact on the life of these Argentine patients. QOL was worse in GO patients than in control group, functional QOL was mostly affected by the activity and appearance QOL was mainly altered by the effects of the disease. Patients with more severe GO had lower scores on both QOL scales.
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Affiliation(s)
- Laura Carolina Delfino
- División Endocrinología, Hospital de Agudos J. M. Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Anabela Zunino
- División Endocrinología, Hospital de Agudos J. M. Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Verónica Sapia
- Servicio de Oftalmología, Hospital de Agudos J. M. Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Verónica Ilera
- División Endocrinología, Hospital de Agudos J. M. Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Alicia Teresa Gauna
- División Endocrinología, Hospital de Agudos J. M. Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
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24
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Taïeb D, Bournaud C, Eberle MC, Catargi B, Schvartz C, Cavarec MB, Faugeron I, Toubert ME, Benisvy D, Archange C, Mundler O, Caron P, Abdullah AE, Baumstarck K. Quality of life, clinical outcomes and safety of early prophylactic levothyroxine administration in patients with Graves' hyperthyroidism undergoing radioiodine therapy: a randomized controlled study. Eur J Endocrinol 2016; 174:491-502. [PMID: 26772985 DOI: 10.1530/eje-15-1099] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/11/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE While radioiodine therapy is commonly used for treating Graves' disease, a prolonged and clinical hypothyroidism may result in disabling symptoms leading to deterioration of quality of life (QoL) of patients. Introducing levothyroxine (LT4) treatment in the early post-therapeutic period may be an interesting approach to limit this phenomenon. METHODS A multicenter, prospective, open-label randomized controlled trial enrolled 94 patients with Graves' hyperthyroidism randomly assigned to the experimental group (n=46) (group A: early prophylactic LT4 treatment) or the control group (n=48) (group B: standard follow-up). The primary endpoint was the 6-month QoL. The secondary endpoints were other QoL scores such as Graves' ophthalmopathy (GO) outcomes, thyroid function tests and safety. RESULTS The primary endpoint at 6 months was achieved: the mental composite score (MCS) of Short Form 36 (SF-36) was significantly higher in group A compared to group B (P=0.009). Four other dimension scores of the SF-36 and four dimension scores of the thyroid-specific patient-reported outcome (ThyPRO) significantly differed between the two groups, indicating better QoL in group A. After adjustment for variables, the early LT4 administration strategy was found as an independent factor for only two scores of SF-36: the MCS and the general health (GH) score. There were no differences in GO, final thyroid status and changes in the anti-TSH receptor antibodies (TRAbs) levels between the two groups. No adverse cardiovascular event was reported. CONCLUSION Early LT4 administration post-radioactive iodine (RAI) could represent a safe potential benefit for patients with regard to QoL. The optimal strategy taking into account administered RAI activities and LT4 treatment dosage and timing remains to be determined.
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Affiliation(s)
- David Taïeb
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology an
| | - Claire Bournaud
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Marie-Claude Eberle
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Bogdan Catargi
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Claire Schvartz
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Marie-Béatrice Cavarec
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Isabelle Faugeron
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Marie-Elisabeth Toubert
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Danielle Benisvy
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Cendrine Archange
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Olivier Mundler
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Philippe Caron
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Ahmad Esmaeel Abdullah
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
| | - Karine Baumstarck
- Department of Nuclear MedicineLa Timone University Hospital, European and Center for Research in Medical Imaging, Aix-Marseille University, 264 rue Saint-Pierre 13385 Marseille Cedex 5, FranceInserm UMR1068 Marseille Cancerology Research CenterInstitut Paoli-Calmettes, Marseille, FranceDepartment of Endocrinology and Nuclear MedicineGHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, FranceDepartment of Nuclear MedicineLapeyronie University Hospital, Montpellier, FranceUniversity Hospital of BordeauxBordeaux, FranceDepartment of Nuclear MedicineJean Godinot Institute, Reims, FranceDepartment of Nuclear MedicineBrest University Hospital, Brest, FranceDepartment of Nuclear MedicineSaint-Antoine Hospital, Paris, FranceDepartment of Nuclear MedicineSaint-Louis Hospital, Paris, FranceDepartment of Nuclear MedicineUniversity of Nice, Nice, FranceDepartment of Endocrinology and Metabolic DiseasesCHU Larrey, Toulouse University Hospital, Toulouse, FranceDepartment of Public HealthEA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France
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Jarusaitiene D, Verkauskiene R, Jasinskas V, Jankauskiene J. Predictive Factors of Development of Graves' Ophthalmopathy for Patients with Juvenile Graves' Disease. Int J Endocrinol 2016; 2016:8129497. [PMID: 27413373 PMCID: PMC4928005 DOI: 10.1155/2016/8129497] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/12/2016] [Indexed: 12/14/2022] Open
Abstract
Background. Due to low incidence of Graves' ophthalmopathy (GO) among children, the manifestation is poorly analyzed, posing a risk to late identification of insidious disease. Purposes. To identify predictive factors that may influence the development of GO in pediatric and young patients with Graves' disease (GD). Methods. A cross-sectional study of patients newly diagnosed with pediatric or juvenile GD during 2002-2012 was conducted at the Hospital of Lithuanian University of Health Sciences. Ocular evaluation was based on European Group on Graves' Orbitopathy survey. The ocular manifestations were analyzed in relation to demographic, environmental, and clinical factors. Results. In total, 130 patients with juvenile GD were included; 29.2% had GO. Median age at GD onset was 17 yrs (IQR 4-29). Main symptoms of GO were eyelids retraction (73.7%), proptosis (65.8%), injection of conjunctiva (42.1%), and eyeball motility disturbance (21.1%). Major significant and independent risk factors for GO development were high initial concentration of FT4 (OR = 5.963), TTHAb (OR = 6.358), stress (OR = 6.030), and smoking (OR = 7.098). Conclusion. The major factors that could influence GO development were smoking, stress, and increased levels of initial TRAb, FT4. Slight proptosis, retraction of eyelids, and conjunctive injection were found as predominant ophthalmological symptoms in juvenile GO.
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Affiliation(s)
- Dalia Jarusaitiene
- Eye Clinic, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania
- *Dalia Jarusaitiene:
| | - Rasa Verkauskiene
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50009 Kaunas, Lithuania
| | - Vytautas Jasinskas
- Eye Clinic, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania
| | - Jurate Jankauskiene
- Eye Clinic, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus 9, LT-44307 Kaunas, Lithuania
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Wickwar S, Mcbain H, Ezra DG, Hirani SP, Rose GE, Newman SP. The Psychosocial and Clinical Outcomes of Orbital Decompression Surgery for Thyroid Eye Disease and Predictors of Change in Quality of Life. Ophthalmology 2015; 122:2568-2576.e1. [DOI: 10.1016/j.ophtha.2015.08.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/10/2015] [Accepted: 08/20/2015] [Indexed: 11/22/2022] Open
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