Endocrine Abstracts

Purpose: The duration of treatment thyroid eye disease (TED) varies substantially between cases, this reflects the understanding that the active phase of the condition can last from 6 to 24 months. This study considers the treatment duration for a number of common symptoms of TED.

Subjects: 746 patients, 155 males and 591 females with mean age 47.7 ± 15.2 years (9-92 years), who first visited Olympia Eye Hospital in 2018 and underwent anti-inflammatory or surgical treatment for TED. Data was examined between 2018-2023.

Methods: Treatments performed over a 5-year period were examined retrospectively. Treatment duration (time from first visit to last anti-inflammatory treatment or surgery) was quantified for patients who underwent subcutaneous triamcinolone acetonide injection (SCTA) for levator palpebrae superioris muscle inflammation, subtenon triamcinolone acetonide injection (STTA) for extraocular muscle inflammation, methylprednisolone pulse therapy for multiple extraocular muscle inflammation, and surgery.

Results: SCTA was performed in 469 cases, STTA in 252 cases, pulse therapy in 210 cases, and surgical treatment in 122 cases (32 orbital decompression in 32, 81 strabismus, and 24 eyelids). The average duration of treatment was 5.1 ± 7.9 months for SCTA only (270 patients), 4.7 ± 9.3 months for STTA only (60 patients), and 8.2 ± 11.0 months for pulse therapy only (52 patients). In those with multiple treatments, cases with pulse therapy, STTA and strabismus surgery had the longest average duration of 19.9 ± 15.8 months. The mean follow-up period was 39.7 ± 24.1 months; 134 patients (17.7%) had been attending the hospital for more than 5 years, with one patient still on anti-inflammatory treatment.

Conclusion: The duration of treatment was shorter in cases in which inflammation could be eliminated by local treatment alone, and longer in cases in involving inflammation of multiple muscles or when strabismus surgery was required. Treated cases had an average follow-up of about 3 years. These treatment durations can help identified those who are refractory to current treatments and might be considered for treatment with new drugs