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Observational Study
. 2023 Nov 21;29(4):171-180.
doi: 10.4103/meajo.meajo_87_23. eCollection 2022 Oct-Dec.

Expanding Understanding of Thyroid Eye Disease Manifestations to Include Hispanic and Black Patients

Tova Goldstein  1 , Marilyn Mostowy  2 , Jennifer Tingley  1 , Gabriel Rand  1 , Jee-Young Moon  3 , Anne Barmettler  1
Affiliations
Observational Study

Expanding Understanding of Thyroid Eye Disease Manifestations to Include Hispanic and Black Patients

Tova Goldstein et al. Middle East Afr J Ophthalmol. .

Abstract

Purpose: Knowledge of thyroid eye disease (TED) is based on predominantly Caucasian populations. To date, no studies in the United States examine the presentation in Black and Hispanic patients. The purpose of this study is to introduce the presentation of TED in two previously undescribed populations.

Methods: This is a retrospective, cross-sectional, chart review study of patients with TED at a tertiary center using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. The main outcome measure for severity was the European Group on Graves' Orbitopathy 2016 Severity Scale.

Results: Of the 2905 charts reviewed, 99 met the inclusion criteria. The mean age was 51 (standard deviation 16) years with 78% women. Race was 49.4% Black, 39.1% Hispanic, 9.2% Caucasian, and 2.3% Asian. Smoking rates were 25% current smokers and 14% former smokers. Manifestations were proptosis (94% Hispanic and 91% Black), eyelid retraction (85% Hispanic and 79% Black), extraocular muscle (EOM) restriction (79% Hispanic and 63% Black), eyelid edema (41% Hispanic and 30% Black), chemosis (24% Hispanic and 14% Black), and optic neuropathy (18% Hispanic and 9% Black). Overall, disease severity was 22% mild, 65% moderate to severe, and 13% sight-threatening. Older patients had increased rates of optic neuropathy (P = 0.04). Younger patients had increased rates of proptosis (P = 0.02). Socioeconomic status was not associated with disease severity (P = 0.67).

Conclusion: Hispanic and Black patients with TED presented with higher than previously established rates of proptosis, EOM restriction, and optic neuropathy. Including research of different races broadens understanding of presentation and management, improving patient outcomes.

Keywords: Black; Hispanic; diversity; extraocular muscle restriction; eyelid edema; optic neuropathy; proptosis; race; retraction; thyroid eye disease.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Rates of thyroid eye disease clinical findings in Black, Hispanic, and Caucasian patients from this study population versus previously established rates in the literature.[2] EOM: Extraocular muscle
Figure 2
Figure 2
Variability in presentation of skin erythema and edema in three active thyroid eye disease patients of different races: (a) Caucasian, (b) Hispanic, and (c) Black
See this image and copyright information in PMC

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