Paediatric Thyroid Eye Disease: clinical features and management
Author: Li Yen Goh
Base Hospital / Institution: Moorfields Eye Hospital
ePoster presentation
Abstract ID: 24-175
Purpose
To review the clinical presentation, disease severity, clinical and surgical management of children with thyroid eye disease at a single quaternary, national referral centre in London, United Kingdom
Methods
Data was collected retrospectively from the start of 2000 to the end of 2023, identifying individuals under the age of 21 years and under 16 years in greater detail.
Results
4882 patients presented to the Moorfield’s sub-specialised TED clinics between 2000 to 2023. Of these 1.92% (94) were under the age of 21 years and 1.04% (51) were under the age of 16 years. Of those 16 years or younger, 46.81% (44/94) were between the ages of 10 to 16 years, 6.38% (6/94) were between 5-9 years and 1.06% (1/94) were less than 5 years of age.
Within the under 16 years group, 25.5% were male (13/51) and 74.5% (38/51) were female. The mean age was 12.33 years (standard deviation: 3.00, range: 4-16) at presentation to the TED clinic. 92.16% (47/51) had hyperthyroidism and 7/84% (4/51) were euthyroid. Most were managed with oral carbimazole for their thyroid dysfunction.
All patients had normal vision with no evidence of dysthyroid optic neuropathy. 74.51% (38/51) presented with proptosis, 19.61% (10/51) had lagophthalmos, 15.69% (8/51) had eyelid swelling, 13.73% (7/51) had chemosis or conjunctival redness and only 7.84% (4/51) had diplopia or obvious extraocular muscle movement abnormalities.
35.29% (18/51) were treated with topical lubricants and only 2.91% (2/51) were treated with systemic steroids. 1.96% (1/51) underwent surgery; bilateral orbital lateral wall decompressions and bilateral eyelid surgery.
Conclusion
In this cohort, children with TED generally exhibit similar signs of the disease to their adult counterparts though in a milder form, with only conservative management needed, which is in agreement with the current subject literature. Paediatric TED tends to affect females more frequently than males, as is the case in autoimmune thyroid disease. Associated strabismus and compressive optic neuropathy were not encountered in the 23 years of experience.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Jimmy | Uddin | Moorfields Eye Hospital |
