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Management of thyroid eye disease in the United Kingdom: A multi-centre thyroid eye disease audit

Lookup NU author(s): Dr Alison Dickinson, Dr Petros Perros, Dr Bijayeswar Vaidya, Dr Anna Mitchell

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Abstract

© 2017 Taylor & Francis This article provides baseline data and highlight any major deficiencies in the current level of care provided for adult patients with thyroid eye disease (TED). We used prospective nonrandomized cross-sectional multicenter observational study. During a 3-month period June–August 2014, consecutive adult patients with TED who presented to nominated specialist eye clinics in the United Kingdom, completed a standardized questionnaire. Main outcome measures were: demographics, time from diagnosis to referral to tertiary centre, time from referral to review in specialist eye clinic, management of thyroid dysfunction, radioiodine and provision of steroid prophylaxis, smoking, and TED classification. 91 patients (mean age 47.88 years) were included. Female-to-male ratio was 6:1. Mean time since first symptoms of TED = 27.92 (73.71) months; from first visit to any doctor with symptoms to diagnosis = 9.37 (26.03) months; from hyperthyroidism diagnosis to euthyroidism 12.45 (16.81) months. First, 13% had received radioiodine. All those with active TED received prophylactic steroids. Seven patients who received radioiodine and did not have TED at the time went on to develop it. Then, 60% patients were current or ex-smokers. 63% current smokers had been offered smoking cessation advice. 65% patients had active TED; 4% had sight-threatening TED. A large proportion of patients (54%) were unaware of their thyroid status. Not enough patients are being provided with smoking cessation advice and information on the impact of smoking on TED and control of thyroid function.


Publication metadata

Author(s): Mellington FE, Dayan CM, Dickinson AJ, Hickey JL, MacEwen CJ, McLaren J, Perros P, Rose GE, Uddin J, Vaidya B, Foley P, Lazarus JH, Mitchell A, Ezra DG, on behalf of The Thyroid Eye Disease Amsterdam Declaration Implementation Group (TEAMeD)

Publication type: Article

Publication status: Published

Journal: Orbit

Year: 2017

Volume: 36

Issue: 3

Pages: 159-169

Online publication date: 15/03/2017

Acceptance date: 02/04/2016

ISSN (print): 0167-6830

ISSN (electronic): 1744-5108

Publisher: Taylor and Francis Ltd

URL: https://doi.org/10.1080/01676830.2017.1280057

DOI: 10.1080/01676830.2017.1280057


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