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Year : 2019  |  Volume : 16  |  Issue : 1  |  Page : 20-25

Pattern of ocular manifestations in patients with thyroid disease presenting in Eastern Nepal

1 Department of Ophthalmology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
2 Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Correspondence Address:
Dr. Poonam Lavaju
Department of Ophthalmology, B.P. Koirala Institute of Health Sciences, Dharan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/trp.trp_38_18

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Purpose: The purpose of this study was to determine the demographic pattern of patients with thyroid disease and to evaluate the clinical activity score (CAS) of patients with thyroid eye disease (TED). Subjects and Methods: A hospital-based cross-sectional study was conducted in patients diagnosed with thyroid dysfunction attending the Outpatient Department of Ophthalmology, Eastern Nepal, from June 2015 to July 2016. Demographic data, complete ocular examinations, thyroid eye signs, severity score (NOSPECS), and CAS were recorded and analyzed. Results: Of the 201 patients with thyroid dysfunction recruited, 40.8% (n = 82) had TED. Among patients with TED, 46 (56%) were hyperthyroid, 34 (41.4%) hypothyroid, and two (2.32%) euthyroid (P = 0.005). The mean duration of thyroid dysfunction in patients with TED was 2.96, median 2 years (P = 0.007). The mean age of the patient was 41.26 ± 11.01 years, with male:female ratio 1:4.7. Exophthalmos was seen in 39%. Eleven patients had diabetes mellitus, ten had hypertension, two myasthenia gravis, and two had cardiovascular disease. Significant association was seen between thyroid status and mean CAS (P < 0.001) and NOSPECS (P < 0.001). Hyperthyroidism was significantly associated with the severity of CAS and NOSPECS (P = 0.006 and P = 0.004, respectively). In logistic regression analysis, the occurrence of TED was influenced by thyroid status (P = 0.005, odds ratio [OR]: 1.79) and mean CAS (P < 0.001, OR: 49.17), age, glaucoma but not by gender, diabetes mellitus, duration of diabetes, hypertension, and cardiovascular disease. Conclusions: TED was more predominant in female and hyperthyroid. A significant associated was seen between hyperthyroid and severity of CAS and NOSPECS. A close synchronization between endocrinologist and ophthalmologist can decrease ocular morbidity.

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