Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Division Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Israel, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2022 Oct;24(10):671-676.
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.
关于多学科甲状腺眼病 (TED) 诊所的成功，知之甚少。
介绍在多学科 TED 诊所接受治疗的患者的特征、治疗方法和结果。
对所有在 TED 诊所就诊的患者进行病历回顾。数据包括人口统计学、病史、实验室检查、视觉功能检查、眼部检查、临床活动评分 (CAS) 和生活质量 (QOL) 评估。
诊所就诊包括在 TED 诊所进行的 385 次就诊中观察到的 132 名患者（每位患者平均 12 次就诊）。TED 的治疗包括对 48 名患者进行药物治疗（36.3%）和对 56 名患者进行手术治疗（42.4%）。在第一次就诊和最后一次随访时，CAS 与甲状腺刺激免疫球蛋白 (TSI) 活性之间存在显著正相关（P < 0.01 和 P < 0.02）。然而，在第一次或最后一次就诊时，CAS 与甲状腺刺激激素水平或游离三碘甲状腺原氨酸 (fT3) 和游离甲状腺素 (fT4) 水平之间均未发现相关性。在第一次就诊时，CAS 与色觉之间存在显著负相关（-0.347，P < 0.01，Pearson 相关），但在第一次或最后一次就诊时，CAS 与视力和视野之间均无相关性。QOL 和 CAS 评分的变化呈显著负相关（-0.240，P < 0.01）。
TED 的治疗和管理决策应基于多个参数，包括眼科医生和内分泌科医生的临床检查、实验室检查以及 CAS 和 QOL 评分。
