Endocrine Abstracts

Introduction: Graves’ Orbitopathy (GO), the most common extrathyroidal manifestation of Graves’ disease (GD), usually presents bilateral disease. However, a minority of patients present with unilateral disease, the prevalence of which is between 4,5% and 14%. The aim of our study is to evaluate the specific demographic and clinical characteristics and potential differences between bilateral and unilateral GO, and the association with disease activity and severity.

Materials and Methods: We conducted an observational study in the outpatient clinic of autoimmune endocrinopathies of the Department of Pathophysiology at Laikon University Hospital. Patients with GD and GO were included in the study. Demographic and clinical characteristics were recorded. We evaluated disease activity with CAS and severity based on EUGOGO consensus. All patients were assessed for TSI levels, TgAbs, TPOAbs and proptosis with Hertel exophthalmometer. Data collected were compared between the two groups of bilateral and unilateral GO.

Results: A total of 102 patients were analyzed. Of whom, 19,6 % presented with unilateral GO. In the bilateral GO patient group mean age was 52.9±13.2 years and 75.6% of them were females. Regarding disease severity, mild, moderate and severe disease accounted for 22.5%, 58.8% and 18.8%, respectively and 64,6% had active disease. The median TSI levels was 9.670 IU/l and the majority of them were negative for TgAbs. Median proptosis for the right eye was 21mm and 20mm for the left. 58% presented with diplopia and 18,3% with strabism. In the unilateral GO patient group the mean age was 56,1±10,7 years and 60% of them were females. Regarding disease severity 40% presented with mild, 35% with moderate and 25% with severe disease. Active disease accounted for 50% of patients. Median TSI levels was 6,55 IU/l and median proptosis was measured 19mm for the right eye and 18,5mm for the left. Diplopia was present in 60% and strabism in 30 %.

Conclusion: In our study, in bilateral GO group the majority of patients presented with moderate disease whereas in unilateral GO group with mild disease. Mean TSI levels and median proptosis were higher in the bilateral GO group. Active disease presented more frequently in bilateral than in unilateral GO group.