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Paper Information

Journal:   BINA   Summer 2003 , Volume 8 , Number 4 (32); Page(s) 287 To 296.
 
Paper: 

OPEN-ANGLE GLAUCOMA, GLAUCOMA SUSPECT, AND OCULAR HYPERTENSION IN GRAVES' ORBITOPATHY

 
 
Author(s):  BEHROOZI Z., MOHAMMAD RABI H., AZIZI F., DAFTARIAN N., ARDESHIRI M., MEHRABI YAD ELAH
 
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Abstract: 

Purpose: To compare the prevalence of open-angle glaucoma (OAG), glaucoma suspect (GS), and ocular hypertension (OHT) among patients with Graves' orbitopathy (GO) admitted to a private endocrinology clinic and a control group.
Methods: This analytic study with convenience sampling was conducted on patients with GO verified by complete systemic and paraclinic examinations by an endocrinologist (A.F.), and a matched control group from companions of patients admitted to the general ophthalmology clinic of Imam Hossein Hospital without any history of documented thyroid disease or orbitopathy and with negative systemic and paraclinic examinations at the time of study. Complete ophthalmologic examinations and intraocular pressure (IOP) measurements in primary position of gaze were performed at least at two different times of day. In case of any type of optic nerve defect or dysfunction, visual field testing by Humphery automated achromatic static perimetry and to rule out compressive optic neuropathy (CON), CT-scan or MRI were performed. OAG, OHT, and (GS) were diagnosed based on characteristic findings and after ruling out the other causes. Classification of Graves' orbitopathy was performed by NOSPECS system and phases of disease activity. Fisher's exact test or chi-square test for qualitative and ANOVA or Hest for quantitative data were used in statistical analysis.
Result: We assessed 233 eyes of 117 patients with GO and 240 eyes of 120 persons in the control group. Mean age
± SD was 39.9±13.4years and 39±14.2years in GO group and control group, respectively. OAG was diagnosed in 6 eyes (2.5%), GS in 5 eyes (2.1%), and OHT in 20 (8.5%) eyes of GO group. From the control group, 2 eyes (0.8%) had OAG. Prevalence of OAG was not statistically different between the two groups, but prevalence of OAG and GS altogether was statistically more in GO than control group (P< 0.02). Prevalence of ocular hypertension with or without optic nerve damage also was statistically more in GO than control group (p<0.001). In GO group, 10 eyes (4.3%) had CON, of these, 5 (2.1%) had also OHT. All OAG and GS eyes were in class 3 or higher of NOSPECS classification. Active phase of GO was observed more in eyes with OHT (p< 0.001), but not for eyes with OAG or GS in GO group.
Conclusion: The prevalence of OAG, GS, and OHT in Graves' orbitopathy is more than the general population. Also the results of this study suggest routine and periodic ophthalmologic examination in patients with GO especially in higher classes of NOSPECS classification and/or active phase of disease.

 
Keyword(s): GRAVES' ORBITOPATHY, OPEN-ANGLE GLAUCOMA, OCULAR HYPERTENSION
 
References: 
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