ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : -1 مورد

Thyroid eye disease severity assessment[1-4]

Thyroid eye disease severity assessment[1-4]
Grade* Lid retraction Soft tissues Proptosis Diplopia Corneal exposure Optic nerve status
Mild <2 mm Mild involvement <3 mm Transient or absent Absent Normal
Moderate-to-severe ≥2 mm Moderate or severe involvement ≥3 mm Inconstant (moderate) or constant (severe) Mild Normal
Sight threatening – – – – Severe Compression
Upper limits of normal
Black populations F/M = 23/24 mm
White populations F/M = 19/21 mm
Asian populations F/M = 16/17 mm (Thai) or 18/19 mm (Chinese)

F: female; M: male; TED: thyroid eye disease.

* Mild TED: patients whose features of TED have only a minor impact on daily life, generally insufficient to justify immunosuppressive or surgical treatment. Moderate-to-severe TED: patients without sight-threatening TED whose eye disease has sufficient impact on daily life to justify the risks of immunosuppression (if active) or surgical intervention (if inactive). Patients with moderate-to-severe TED usually have any 1 or more of the following: lid retraction ≥2 mm, moderate or severe soft tissue involvement, proptosis ≥3 mm above normal for race and sex, or diplopia. Sight-threatening TED: patients with dysthyroid optic neuropathy and/or corneal breakdown. This category warrants immediate intervention.

¶ Proptosis refers to the variation compared with the upper limit of normal for each race/sex or the patient's baseline, if available.
References:
  1. de Juan E Jr, Hurley DP, Sapira JD. Racial differences in normal values of proptosis. Arch Intern Med 1980; 140:1230.
  2. Sarinnapakorn V, Sridama V, Sunthornthepvarakul T. Proptosis in normal Thai samples and thyroid patients. J Med Assoc Thai 2007; 90:679.
  3. Tsai CC, Kau HC, Kao SC, Hsu WM. Exophthalmos of patients with Graves' disease in Chinese of Taiwan. Eye (Lond) 2006; 20:569.
  4. Bartalena L, Baldeschi L, Dickinson AJ, et al. Consensus statement of the European group on Graves' orbitopathy (EUGOGO) on management of Graves' orbitopathy. Thyroid 2008; 18:333.

Reproduced with permission from: Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid 2016; 26:1343. Copyright © 2016 Mary Ann Liebert, Inc. publishers.

Guidance for this table reaffirmed in the following publications:

  • Bartalena L, Kahaly GJ, Baldeschi L, et al. The 2021 European Group on Graves' orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves' orbitopathy. Eur J Endocrinol 2021; 185:G43.
  • Burch HB, Perros P, Bednarczuk T, et al. Management of thyroid eye disease: A consensus statement by the American Thyroid Association and the European Thyroid Association. Thyroid 2022; 32:1439.
Graphic 116360 Version 4.0