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.2017 Dec;79(6):521-526.
doi: 10.1007/s12262-016-1516-8. Epub 2016 Jun 22.

Regression of Ophthalmopathic Exophthalmos in Graves' Disease After Total Thyroidectomy: a Prospective Study of a Surgical Series

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Regression of Ophthalmopathic Exophthalmos in Graves' Disease After Total Thyroidectomy: a Prospective Study of a Surgical Series

P R K Bhargav et al. Indian J Surg.2017 Dec.

Abstract

Autoimmune ophthalmopathy is one of the salient clinical features associated with Graves' disease. Exophthalmos is one of the commonest manifestations of Graves' associated ophthalmopathy. It is reported to regress after thyroidectomy favourably compared to radioiodine or antithyroid drug therapy. In this context, we present our experience based on a surgical series of Graves' disease. This is a prospective study of 15 patients of Graves' disease associated with ophthalmopathic exophthalmos. Preoperative and monthly postoperative evaluation of exophthalmos was done with Hertel's exophthalmometer, apart from documenting lid, extra-ocular muscle and orbital involvement. The minimum follow-up of the cohort was 12 months. The female to male ratio was 12:3 and the mean age of the subjects was 33.4 years (18-55). Exophthalmos was bilateral in 13 and unilateral in 2 patients. All the 15 patients underwent total thyroidectomy without any major morbidity. Exophthalmos regressed in 12 patients at a mean follow-up of 15.6 ± 6.4 months (14-38) and was static in 3. None of the cases had worsened ophthalmopathy at the final follow-up. Mean regression of exophthalmos was 2.1 mm (1-5). The regression was statistically significant atP value = 0.035. Surgery has a positive impact on the regression of ophthalmopathic exophthalmos associated with Graves' disease.

Keywords: Exophthalmos; Graves’ disease; Ophthalmopathy; Regression; Total thyroidectomy.

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Conflict of interest statement

Conflict of Interest

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Bilateral regression of GAE at last follow-up of 30 months [Markers placed for PFH comparison before (left) and after (right) surgery.]
Fig. 2
Fig. 2
Right eye complete and left eye partial regression of GAE at 15 months follow-up [Markers placed for PFH comparison before (left) and after (right) surgery.]
Fig. 3
Fig. 3
Regression of unilateral (left-sided) GAE at 12 months follow-up [Markers placed for PFH comparison before (left) and after (right) surgery.]
See this image and copyright information in PMC

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