A Multidisciplinary Thyroid Eye Clinic: A One-stop Shop.


Journal

The Israel Medical Association journal : IMAJ
ISSN: 1565-1088
Titre abrégé: Isr Med Assoc J
Pays: Israel
ID NLM: 100930740

Informations de publication

Date de publication:
Oct 2022
Historique:
entrez: 30 10 2022
pubmed: 31 10 2022
medline: 2 11 2022
Statut: ppublish

Résumé

Little is known about the success of multidisciplinary thyroid eye disease (TED) clinic. To present the characteristics, treatments, and outcomes of patients treated in a multidisciplinary TED clinic. A medical record review of all patients who attended a TED clinic was performed. Data included demographics, medical history, laboratory tests, visual function tests, ocular examinations, clinical activity score (CAS), and assessment of quality-of-life (QOL). Clinic visits included 132 patients seen during 385 appointments at a TED clinic (mean 12 appointments per patient). Management of TED included medical treatments for 48 patients (36.3%) and surgical treatment for 56 (42.4%). There was a positive significant correlation between the CAS and thyroid-stimulating immunoglobulin (TSI) activity at the first visit and at the last follow-up visit (P < 0.01 and P < 0.02, respectively). However, no correlation was found between the CAS and the thyroid-stimulating hormone levels or between the free triiodothyronine (fT3) and fT4 levels at the first or last visit. There was a significant negative correlation between the CAS and color vision (-0.347, P < 0.01, Pearson correlation) at the first visit, but not between the CAS and visual acuity and visual field at either the first or last visit. Changes in the QOL and the CAS scores were significantly negatively correlated (-0.240, P < 0.01). Treatment and management decisions for TED should be based on multiple parameters including clinical examinations by ophthalmologists and endocrinologists, laboratory tests, and CAS and QOL scores.

Sections du résumé

BACKGROUND BACKGROUND
Little is known about the success of multidisciplinary thyroid eye disease (TED) clinic.
OBJECTIVES OBJECTIVE
To present the characteristics, treatments, and outcomes of patients treated in a multidisciplinary TED clinic.
METHODS METHODS
A medical record review of all patients who attended a TED clinic was performed. Data included demographics, medical history, laboratory tests, visual function tests, ocular examinations, clinical activity score (CAS), and assessment of quality-of-life (QOL).
RESULTS RESULTS
Clinic visits included 132 patients seen during 385 appointments at a TED clinic (mean 12 appointments per patient). Management of TED included medical treatments for 48 patients (36.3%) and surgical treatment for 56 (42.4%). There was a positive significant correlation between the CAS and thyroid-stimulating immunoglobulin (TSI) activity at the first visit and at the last follow-up visit (P < 0.01 and P < 0.02, respectively). However, no correlation was found between the CAS and the thyroid-stimulating hormone levels or between the free triiodothyronine (fT3) and fT4 levels at the first or last visit. There was a significant negative correlation between the CAS and color vision (-0.347, P < 0.01, Pearson correlation) at the first visit, but not between the CAS and visual acuity and visual field at either the first or last visit. Changes in the QOL and the CAS scores were significantly negatively correlated (-0.240, P < 0.01).
CONCLUSIONS CONCLUSIONS
Treatment and management decisions for TED should be based on multiple parameters including clinical examinations by ophthalmologists and endocrinologists, laboratory tests, and CAS and QOL scores.

Identifiants

pubmed: 36309864

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

671-676

Auteurs

Ofira Zloto (O)

Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Oded Sagiv (O)

Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ayelet Priel (A)

Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Tali Cukierman-Yaffe (T)

Division Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Israel, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Amir Tirosh (A)

Division Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Israel, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Nancy Agmon-Levin (N)

Department of Clinical Immunology, Angioedema and Allergy, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Shiran Madgar (S)

Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Tal Serlin (T)

Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Halit Winter (H)

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ruth Huna-Baron (R)

Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Tamara Wygnanski-Jaffe (T)

Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Guy Ben Simon (G)

Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

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