Ofira Zloto, M.D., Oded Sagiv, M.D., Ayelet Priel, M.D., Tali Cukierman-Yaffe, M.D., Amir Tirosh, M.D. , Nancy Agmon-Levin, M.D., Shiran Madgar, M.D., Tal Serlin, M.D., Halit Winter, M.D. Ruth Huna-Baron, M.D., Tamara Wygnanski-Jaffe, M.D., Guy Ben Simon, M.D.
Background: Little is known about the success of multidisciplinary thyroid eye disease (TED) clinic.
Objectives: To present the characteristics, treatments, and outcomes of patients treated in a multidisciplinary TED clinic.
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: 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: 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.