Predictive demographic and clinical features for the development of dysthyroid optic neuropathy in a multi-ethnic TED population: A Retrospective Cohort Study.
Author(s)
Lee, Vickie
Type
Journal Article
Abstract
Background:
Dysthyroid Optic Neuropathy (DON) is a sight-threatening complication of Thyroid Eye Disease (TED). This study aims to identify the risk and predictive factors for DON in a multi-ethnic TED cohort.
Methods:
Retrospective, cohort study of consecutive TED patients attending a multidisciplinary service over an 11-year period. Consecutive patients aged over 18 years old with a minimum of 6 months follow-up post-diagnosis of TED were included. We compared those patients with DON and those without (no-DON) to determine which factors were more prevalent in patients with DON.
Results:
There were 26 and 516 consecutive patients with DON and no-DON. The DON prevalence in the cohort was 5.0%.
The DON group had a Mean Age at TED Diagnosis (MATD) of 57.8 vs 46.1 years in the no-DON group. The mean presenting CAS, TRAb and Gorman Diplopia Score (GDS) were significantly higher 3.73±1.80, 2.76±1.05 and 11.31±11.90 vs 0.54±0.80, 0.48±0.90 and 6.95±9.22 in the DON compared to the no-DON group respectively (p=0.00, p=0.00 and p=0.04). On multivariable regression, we found the following risk factors for developing DON (Odds Ratios): MATD ≥53 years (5.2 p=0.00), presenting CAS ≥4 (P=0.00), presenting GDS ≥3 (7.5 p=0.00), diabetes (5.7 p=0.00), and baseline TRAb ≥5.0 IU/L (2.9 p=0.04).
Conclusion:
Patients with diabetes, increased MATD, and high presenting CAS, GDS, and TRAb are at increased risk of developing DON in our cohort. Clinicians should be especially vigilant of the risk of sight-threatening complications in TED patients with more than one of the above risk factors.
Dysthyroid Optic Neuropathy (DON) is a sight-threatening complication of Thyroid Eye Disease (TED). This study aims to identify the risk and predictive factors for DON in a multi-ethnic TED cohort.
Methods:
Retrospective, cohort study of consecutive TED patients attending a multidisciplinary service over an 11-year period. Consecutive patients aged over 18 years old with a minimum of 6 months follow-up post-diagnosis of TED were included. We compared those patients with DON and those without (no-DON) to determine which factors were more prevalent in patients with DON.
Results:
There were 26 and 516 consecutive patients with DON and no-DON. The DON prevalence in the cohort was 5.0%.
The DON group had a Mean Age at TED Diagnosis (MATD) of 57.8 vs 46.1 years in the no-DON group. The mean presenting CAS, TRAb and Gorman Diplopia Score (GDS) were significantly higher 3.73±1.80, 2.76±1.05 and 11.31±11.90 vs 0.54±0.80, 0.48±0.90 and 6.95±9.22 in the DON compared to the no-DON group respectively (p=0.00, p=0.00 and p=0.04). On multivariable regression, we found the following risk factors for developing DON (Odds Ratios): MATD ≥53 years (5.2 p=0.00), presenting CAS ≥4 (P=0.00), presenting GDS ≥3 (7.5 p=0.00), diabetes (5.7 p=0.00), and baseline TRAb ≥5.0 IU/L (2.9 p=0.04).
Conclusion:
Patients with diabetes, increased MATD, and high presenting CAS, GDS, and TRAb are at increased risk of developing DON in our cohort. Clinicians should be especially vigilant of the risk of sight-threatening complications in TED patients with more than one of the above risk factors.
Date Issued
2025-07-22
Date Acceptance
2024-05-22
Citation
Thyroid Research, 2025, 18
ISSN
1756-6614
Publisher
BMC
Journal / Book Title
Thyroid Research
Volume
18
Copyright Statement
© The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Publication Status
Published
Article Number
ARTN 37