Oral abstract presentation times

Purpose

To evaluate the long-term natural course, and progression rate in patients with mild Graves’ orbitopathy (GO), and to identify potential baseline predictors of disease progression.

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Methods

This retrospective longitudinal cohort study included patients diagnosed with mild GO between 2013 and 2023 at a tertiary referral center. Patients were classified according to EUGOGO criteria and followed for a minimum of 3 years. Demographic characteristics, medical and family history, thyroid function tests, thyroid antibody levels, ophthalmologic findings, and GO-related ophthalmic surgical history were evaluated at presentation and at the final visit. The primary outcome was disease progression rate, regarding clinical activity score (CAS), and EUGOGO severity classification during follow-up.

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Results

A total of 341 mild GO patients were included. The mean age was 41.8 ± 13.0 years, and 251 (73.6%) of the patients were female. Mean follow-up duration was 89.8 ± 36.1 months. 14 (4.1%) patients showed increased CAS and/or disease severity. Intravenous steroid treatment was administered to 8 patients (2.7 %), lower and/or upper eyelid procedures were performed in 27 patients (7.9%), orbital decompression was performed in 13 patients (3.8%), and strabismus surgery was performed in 6 patients (1.8%). CAS, MRD-1, MRD-2, diplopia score, Hertel measurements, and eyelid retraction showed significant improvement at the final visit compared with baseline (p < 0.05). In the regression analysis, none of the evaluated clinical factors showed a significant association with disease progression.

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Conclusion

This is the first study from Türkiye, an endemic region for GO, to evaluate the long-term follow-up outcomes of patients with mild GO. Although mild GO usually has a self-limiting course, disease progression may occur in a small proportion of patients, and systemic steroid treatment or surgical intervention may be required. Therefore, regular follow-up of patients with mild GO is important.

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Additional Authors

First name	Last name	Base Hospital / Institution
Bercin	Tarlan	Faculty of Medicine, Department of Ophthalmology, Gazi University, Ankara, Turkey
Mehmet Muhittin	Yalcin	Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, Turkey
Goksun	Ayvaz	Department of Endocrinology and Metabolism, Koru Hospital, Ankara, Turkey.
Fusun	Balos Toruner	Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, Turkey
Onur	Konuk	Faculty of Medicine, Department of Ophthalmology, Gazi University, Ankara, Turkey

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