Even in the chronic phase, the quality of life of patients with thyroid eye disease is generally still very poor

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Introduction: In the past, it was believed that the burden of disease caused by thyroid eye disease would gradually decrease in the chronic phase as the treatment progresses.
However, a latest survey data shows that although the chronic phase inflammation can be relieved, symptoms and signs often still exist, even if After receiving glucocorticoid treatment or surgery, the quality of life of most patients is still very low.

Study description Cockerham and colleagues analyzed the survey data of 100 adults with inactive or chronic thyroid eye disease (the average age of the participants was 45 years old, the proportion of women was 47%, the proportion of whites was 81%, and the proportion of smokers was 13%.
The average duration of thyroid eye disease is 5.
8 years).

Researchers use the Graves Eye Disease Quality of Life Scale to assess the quality of life of participants.
The score ranges from 0-100 points (the best), and 90-100 points are considered normal.

According to the score, the patients were stratified and analyzed: low (≤59), medium (50-75) and high (≥75).

The average score was only passing, and symptoms such as orbital pain and blurred vision caused persistent distress.
The results showed that the average overall quality of life score of the patients was 60.
5 points, the average appearance score was 58.
6 points, and the average visual function score was 62.
3 points.

Patients with the lowest quality of life scores reported the most signs and symptoms of thyroid ophthalmopathy, of which orbital pain, blurred vision, sensitivity to light, and diplopia had the greatest impact on life.

 When thyroid eye disease was first diagnosed, 57% of respondents reported dryness and grit, 54% reported pain behind the eye, 49% reported headache, and 48% reported light sensitivity.

However, even in the chronic phase of the disease, up to 47% of respondents reported persistent dryness and grit, 25% reported pain behind the eyes, 33% reported headaches, and 27% reported sensitivity to light.

 Surgery/glucocorticoid therapy did not significantly improve the quality of life of patients.
In this cohort, 25 patients received oral/intravenous glucocorticoid therapy during active disease.

There was no significant difference in the quality of life scores between patients receiving or not receiving glucocorticoid therapy, and patients receiving intravenous treatment had lower quality of life scores.

Similarly, whether or not to receive surgical treatment did not significantly affect the quality of life of patients in the chronic phase.

 The author of the study called on one of the authors of this study, Dr.
Cockerham from the Stanford University School of Medicine, to mention: "The results are somewhat unexpected.
In this study, we found that the quality of life of patients with thyroid eye disease in the chronic phase was significantly reduced.
Almost the same as clinical trials for patients with acute, moderate to severe diseases.

This is very different from traditional cognition.
In the past, we believed that once patients progress to the chronic stage of thyroid ophthalmopathy, related symptoms will be reduced and the overall quality of life will increase accordingly.
.

This study suggests that clinicians should be aware that, even in the chronic stage, thyroid eye disease can significantly affect the quality of life of patients and affect various aspects of mental health, such as anxiety or depression.

by asking patients about thyroid eye disease How symptoms affect life, such as sleep, work, and society, doctors can better understand the full impact of the disease, and ultimately make more informed treatment decisions to help patients.

” Source: Cockerham K, et al.
Abstract # 129.
Presented at: North American Neuro-Ophthalmology Society Annual Meeting; Feb.
20-23, 2021 (virtual meeting).