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Meta-Analysis
. 2020 Oct;93(4):363-374.
doi: 10.1111/cen.14296. Epub 2020 Aug 10.

Prevalence of thyroid eye disease in Graves' disease: A meta-analysis and systematic review

Yip Han Chin  1 , Cheng Han Ng  1 , Ming Hui Lee  2 , Jeffery Wei Heng Koh  3 , Jolene Kiew  4 , Samantha Peiling Yang  1   4 , Gangadhara Sundar  5 , Chin Meng Khoo  1   4
Affiliations
Meta-Analysis

Prevalence of thyroid eye disease in Graves' disease: A meta-analysis and systematic review

Yip Han Chin et al. Clin Endocrinol (Oxf). 2020 Oct.

Abstract

Objective: Thyroid eye disease (TED) is a debilitating condition that frequently manifests in patients suffering from Graves' disease (GD). This study aims to analyse the prevalence of TED among GD patients, with a focus on geographical region-specific rates.

Methods: Medline and Embase were searched for articles examining TED prevalence on April 2020, and articles were retrieved and sieved. Statistical analysis was performed after Freeman-Tukey double arcsine transformation. Thereafter, results were pooled with random effects by DerSimonian and Laird model.

Results: Fifty-seven articles involving 26,804 patients were included in the review. The overall pooled prevalence of TED was 40% (CI: 0.32 to 0.48) and by continent was 38% (CI: 0.31 to 0.46) for Europe, 44% (CI: 0.32 to 0.56) for Asia, 27% (CI: 0.06 to 0.56) for North America and 58% (CI: 0.55 to 0.61) for Oceania. The prevalence of TED in Southeast Asia was 35% (CI: 0.24 to 0.47) and Middle East 48% (CI: 0.19 to 0.78). Subgroup analysis showed regions with predominantly Caucasians (37%; CI: 0.28 to 0.46) had a lower prevalence of TED compared to Asians (45%; CI: 0.33 to 0.58). The pooled prevalence of lid retraction was 57% (CI: 0.39 to 0.74), proptosis 57% (CI: 0.48 to 0.65), diplopia 36% (CI: 0.24 to 0.48) and ocular hypertension 13% (CI: 0.06 to 0.19).

Conclusion: A substantial proportion of patients with GD have TED and often manifest as lid retraction, proptosis and diplopia. Early detection through active screening might help to mitigate the progression of TED and its associated complications.

Keywords: Graves’ disease; Graves’ ophthalmopathy; eye diseases; geographical locations; meta-analysis; prevalence; thyroid diseases.

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References

REFERENCES

    1. Choi YJ, Lim HT, Lee SJ, Lee SY, Yoon JS. Assessing Graves' ophthalmopathy-specific quality of life in Korean patients. Eye (Lond). 2012;26(4):544-551.
    1. Kendler DL, Lippa J, Rootman J. The initial clinical characteristics of Graves' orbitopathy vary with age and sex. Arch Ophthalmol. 1993;111(2):197-201.
    1. Stan MN, Bahn RS. Risk Factors for Development or Deterioration of Graves' Ophthalmopathy. Thyroid. 2010;20(7):777-783.
    1. Träisk F, Tallstedt L, Abraham-Nordling M, et al. Thyroid-associated ophthalmopathy after treatment for Graves' hyperthyroidism with antithyroid drugs or iodine-131. J Clin Endocrinol Metab. 2009;94(10):3700-3707.
    1. Vestergaard P. Smoking and thyroid disorders - A meta-analysis. Eur J Endocrinol. 2002;146(2):153-161.

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