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

F. E. Mellington (Lead / Corresponding author), C. M. Dayan, A. J. Dickinson, J. L. Hickey, C. J. MacEwen, J. McLaren, P. Perros, G. E. Rose, J. Uddin, B. Vaidya, P. Foley, J. H. Lazarus, A. Mitchell, D. G. Ezra, Thyroid Eye Disease Amsterdam Declaration Implementation Group (TEAMeD)

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    8 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)159-169
    Number of pages11
    JournalOrbit
    Volume36
    Issue number3
    Early online date15 Mar 2017
    DOIs
    Publication statusPublished - 2017

    Keywords

    • Journal article
    • Thyroid eye disease
    • Thyroid function
    • Amsterdam declaration
    • Smoking
    • Radioiodine

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