Research Article
Determinants of Favourable Outcome Among Adults with Active Thyroid Eye Disease: The Remarkable Role of Long-Duration Treatment Approaches
Joaquim Rutllan-Civit*,
Fayna Rodríguez-González,
Bárbara Salas-Salas,
Laura Ferrera,
Lucía Juan,
Raquel Cabrera,
Marta Lloret,
Francisco Medina-Rivero,
Jesús-María González-Martín,
Pedro De Pablos-Velasco
Issue:
Volume 9, Issue 1, April 2024
Pages:
1-7
Received:
27 December 2023
Accepted:
9 January 2024
Published:
18 January 2024
Abstract: Background: The response to treatment in adult patients suffering from thyroid-eye-disease is variable, with resistant and relapsing cases. Clinical and therapeutic factors involved are not well established. Objectives: To identify clinical determinants of favourable outcome in a sample of adults with active thyroid orbitopathy who received multidisciplinary treatment and to evaluate the effect of long duration treatment approaches for moderate-to-severe cases. Methods: This retrospective observational study included patients treated in a hospital environment with a follow-up of more than 1 year. The criteria for a favourable outcome after treatment were a final Clinic Activity Score (CAS) < 2 and fewer than 3 posttreatment visits with a CAS > 1. The treatments used for moderate-to-severe orbitopathy were categorized according to duration. The following were considered long-duration treatments (LDTs): radiotherapy combined with intravenous corticosteroids; and tocilizumab. These LDTs were compared with treatments that were administered for up to 3 months. Fisher’s and Mann‒Whitney tests were used to verify relationships between qualitative and quantitative variables. Logistic and linear regressions were used to predict dichotomous and numerical variables. Results: Seventy-two patients were included in the study. Active smoking and sustained endocrine disease were associated with a longer duration of active orbitopathy (p = 0.045 and p <0.001, respectively). Radioiodine-induced hypothyroidism and arterial hypertension were negatively correlated with a favourable outcome event, with ORs of 0.12 (p = 0.008) and 0.16 (p = 0.019), respectively. LDTs were determinants of favourable outcome, with an odds ratio of 6.85 (p = 0.015). LDTs also led to a greater decrease in the CAS (p = 0.03). Conclusion: Active smoking, radioiodine-induced hypothyroidism, arterial hypertension, and sustained endocrine disease are associated with non-favourable outcome after treatment. LDTs contribute to favourable outcomes in adult patients with active moderate-to severe thyroid ophthalmopathy.
Abstract: Background: The response to treatment in adult patients suffering from thyroid-eye-disease is variable, with resistant and relapsing cases. Clinical and therapeutic factors involved are not well established. Objectives: To identify clinical determinants of favourable outcome in a sample of adults with active thyroid orbitopathy who received multidi...
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Research Article
A Study of Visual Rehabilitation and Intraocular Pressure Control in Phacolytic Glaucoma
Sheikh Asma Bashir,
Imtiyaz Ahmad Lone*,
Fayka Mohi-Ud-Din Wani,
Qazi Afshana Sumaiya
Issue:
Volume 9, Issue 1, March 2024
Pages:
8-12
Received:
26 December 2023
Accepted:
16 January 2024
Published:
24 May 2024
Abstract: Purpose: To evaluate the visual recovery and intraocular pressure control after cataract surgery in patients of phacolytic glaucoma. Methods: 23 patients diagnosed clinically as phacolytic glaucoma and included in the study were operated upon using either SICS or Phacoemulsification procedure after lowering of the Intraocular pressure (IOP) and control of ocular inflammation. Results: Post-operatively 21.73% of patients achieved a best corrected visual acuity (BCVA) of 6/60-6/12, 43.82% had a BCVA of 4/60-6/60 and 30.43% achieved a final BCVA between 4/60 to only perception of light. However 86.95% of patients maintained an IOP less than 20 mm Hg, 8.69% had an IOP between 20-23 mm Hg and 4.34% had an IOP between 24-30 mm Hg requiring a Glaucoma filtering surgery. Conclusion: Patients of Phacolytic Glaucoma if present at an early stage can have a good visual recovery and well controlled IOP in the post-operative period.
Abstract: Purpose: To evaluate the visual recovery and intraocular pressure control after cataract surgery in patients of phacolytic glaucoma. Methods: 23 patients diagnosed clinically as phacolytic glaucoma and included in the study were operated upon using either SICS or Phacoemulsification procedure after lowering of the Intraocular pressure (IOP) and con...
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