The treatment of Graves' ophthalmopathy in an incidence cohort.

Abstract:

PURPOSE:To determine the frequencies of medical and surgical treatments in an incidence cohort of 120 patients with Graves' ophthalmopathy. METHODS:We reviewed the community medical records and administered a follow-up questionnaire. RESULTS:Of the 120 patients, 89 (74.2%) required either no therapy or only supportive measures. Six patients (5.0%) were treated with systemic corticosteroids. One patient had orbital radiotherapy. Twenty-four patients (20.0%) underwent one or more surgical procedures. The cumulative probabilities of undergoing ophthalmic surgery of any type were 5.0% by one year after the diagnosis of ophthalmopathy, 9.3% after two years, 15.9% after five years, and 21.8% after ten years. The need for surgery was significantly related to age (P < .01; Cox proportional hazards model) but was not significantly dependent on gender (P = .5) or the interaction of age and gender (P = .15). The overall risk of the need for surgery was 2.6 times greater in patients older than 50 years (95% confidence interval, 1.2 to 5.8) than in younger patients. There were no significant differences between tobacco smokers and nonsmokers in the cumulative probabilities of undergoing surgery. CONCLUSION:In 24 (20%) patients, one or more surgical procedures were used to treat Graves' ophthalmopathy. The probability of surgical intervention was significantly related to patient age (older than 50 years), but it was not related to gender or smoking.

journal_name

Am J Ophthalmol

authors

Bartley GB,Fatourechi V,Kadrmas EF,Jacobsen SJ,Ilstrup DM,Garrity JA,Gorman CA

doi

10.1016/s0002-9394(14)70585-9

subject

Has Abstract

pub_date

1996-02-01 00:00:00

pages

200-6

issue

2

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(14)70585-9

journal_volume

121

pub_type

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