Management of patients in a combined thyroid eye clinic in secondary care

2.50
Hdl Handle:
http://hdl.handle.net/11287/593793
Title:
Management of patients in a combined thyroid eye clinic in secondary care
Authors:
Benzimra, James D.; Quinn, Anthony G.; Kersey, T.; McGrane, D.; Goss, Lynne; Vaidya, Bijay
Abstract:
The European Group on Graves' Orbitopathy (EUGOGO) recommends the use of specialised multidisciplinary clinics for the management of thyroid eye disease (TED). In the UK, many patients with TED are managed outside of specialised clinics. We describe the organisation of a combined TED clinic in a secondary care setting and present the result of a prospective audit of the patient characteristics and outcomes during the first four years of a combined TED clinic. Of a total of 132 patients referred to the TED clinic, 114 (86 %) had TED (90 females, median age 56 years; range 17-90 years). At presentation, 77 (67 %) were current or ex-smokers and 99 (87 %) were biochemically euthyroid. Median duration of eye symptoms was 12 months. Fifty-two percent, 45 and 3 had mild, moderate-to-severe and sight-threatening TED, respectively. Only 18 % of patients had a clinical activity score (CAS) of >/=3. Sixty-nine patients (61 %) required follow-up appointments in the TED clinic. In those who required follow-up, 43 % (n = 30) received either immunosuppressive or surgical treatment. CAS improved from first to final visit, with 29 % (n = 20) having a CAS of >/=3 at the first visit and 1 % (n = 1) at the final visit (p = 0.0001). There was also a decrease in prevalence of smoking and thyroid dysfunction at the final visit. A multidisciplinary specialised TED clinic offers an optimal setting for managing patients with TED; however, patients are often referred late to a specialist TED clinic.
Citation:
Int Ophthalmol. 2014 Feb;34(1):1-6.
Publisher:
Springer
Journal:
International ophthalmology
Issue Date:
1-Feb-2014
URI:
http://hdl.handle.net/11287/593793
DOI:
10.1007/s10792-013-9768-9
PubMed ID:
23549634
Additional Links:
http://dx.doi.org/10.1007/s10792-013-9768-9
Type:
Journal Article
Language:
eng
ISSN:
1573-2630
Appears in Collections:
2014 RD&E publications; Diabetes/Endocrine Services

Full metadata record

DC FieldValue Language
dc.contributor.authorBenzimra, James D.en
dc.contributor.authorQuinn, Anthony G.en
dc.contributor.authorKersey, T.en
dc.contributor.authorMcGrane, D.en
dc.contributor.authorGoss, Lynneen
dc.contributor.authorVaidya, Bijayen
dc.date.accessioned2016-01-19T12:34:59Zen
dc.date.available2016-01-19T12:34:59Zen
dc.date.issued2014-02-01en
dc.identifier.citationInt Ophthalmol. 2014 Feb;34(1):1-6.en
dc.identifier.issn1573-2630en
dc.identifier.pmid23549634en
dc.identifier.doi10.1007/s10792-013-9768-9en
dc.identifier.urihttp://hdl.handle.net/11287/593793en
dc.description.abstractThe European Group on Graves' Orbitopathy (EUGOGO) recommends the use of specialised multidisciplinary clinics for the management of thyroid eye disease (TED). In the UK, many patients with TED are managed outside of specialised clinics. We describe the organisation of a combined TED clinic in a secondary care setting and present the result of a prospective audit of the patient characteristics and outcomes during the first four years of a combined TED clinic. Of a total of 132 patients referred to the TED clinic, 114 (86 %) had TED (90 females, median age 56 years; range 17-90 years). At presentation, 77 (67 %) were current or ex-smokers and 99 (87 %) were biochemically euthyroid. Median duration of eye symptoms was 12 months. Fifty-two percent, 45 and 3 had mild, moderate-to-severe and sight-threatening TED, respectively. Only 18 % of patients had a clinical activity score (CAS) of >/=3. Sixty-nine patients (61 %) required follow-up appointments in the TED clinic. In those who required follow-up, 43 % (n = 30) received either immunosuppressive or surgical treatment. CAS improved from first to final visit, with 29 % (n = 20) having a CAS of >/=3 at the first visit and 1 % (n = 1) at the final visit (p = 0.0001). There was also a decrease in prevalence of smoking and thyroid dysfunction at the final visit. A multidisciplinary specialised TED clinic offers an optimal setting for managing patients with TED; however, patients are often referred late to a specialist TED clinic.en
dc.language.isoengen
dc.publisherSpringeren
dc.relation.urlhttp://dx.doi.org/10.1007/s10792-013-9768-9en
dc.titleManagement of patients in a combined thyroid eye clinic in secondary careen
dc.typeJournal Articleen
dc.identifier.journalInternational ophthalmologyen

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