Ophthalmic abnormalities in Graves' Disease: 169 cases report

Ayrton R. B. Ramos Maurício Maia Lúcio H. Matsumoto Leonardo T. Matsumoto Carlos A. Moreira Jr Hans Graf About the authors

SUMMARY

The purposes of this study are to report the most frequent ophthalmologic findings in Graves’ Disease, discuss some controversial standpoints due to clinical findings of ocular abnormalities and prove the neccessity of ophthalmic exam in these patients. We established a protocol to better evaluate the patients with ophthalmopathy in order to standardize the first ophthalmic exam in these patients, evaluating the main signs and symptoms. The results were analysed using the qui-square method. One hundred and sixty nine patients with Graves'

Ophthalmopathy between the ages of 04 and 82 (36.23 ± 13.16) were examinated. The most part of patients were white (89.1%) and female (77.56%). The main complain was foreign body sensation (63.03%). One hundred and fifty (90.9%) patients had 20/25 visual acuity (VA) or better in the best eye after optic correction. One hundred and eight (66.26%) had ocular motion limitation or lid retraction. Seventy nine (47.88%) had alterations in the exophthalmometry at least in one eye. Stippling of cornea was found in 77 (46.66%) patients. Twelve (7.27%) had raised intraocular pressure (lOP) only, and 4 (2.42%) fundus abnormalities. Ocular motion alteration, proptosis and cornea alterations were the main signs. Poor visual acuity, ocular pain and foreign body sensation were the most frequent symptoms. We proved that is necessary an early ophthalmic exam in these patients, including the patients who did not have hyperthyroidism in the moment of ocular exam. Clinical stage and differences of sex and race (p>0.05) were not related to ocular findings, except proptosis which was less in the black people group (p<0.05).

Key-words:
Graves' Disease; Graves' Ophthalmopathy; Ocular findings; Clinical evaluation; Early diagnosis

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