Pediatric Graves’ orbitopathy: a multicentre study
Acta Ophthalmologica, vol. 100, pp. e1340–e1348
Abstract
PURPOSE: Graves' orbitopathy (GO) is a rare condition in children often considered to be a less severe condition than at an older age. The aim of our study was to analyse if there are any factors that distinguish paediatric from adult GO in order to provide guidelines for assessing and managing paediatric GO. METHODS: Study design is a multicentre retrospective observational case series; 115 paediatric patients diagnosed with GO who visited our university medical centres in the Netherlands and Iran between 2003 and 2019 were submitted for complete ophthalmological examinations, serological testing and/or orbital imaging. Main outcome measures focussed on the natural course and clinical picture as well as medical and surgical treatment in paediatric GO. RESULTS: Clinical findings included proptosis (n = 97; 84.3%), eyelid retraction (n = 77; 67%) and diplopia (n = 13; 11.3%). Ninety-two patients (80%) presented with mild disease, 21 (18.3%) with moderate-severe disease and two (1.7%) with severe GO. Five patients (4.3%) underwent intravenous glucocorticoids and 25 patients underwent orbital decompression surgery. Strabismus surgery due to primary involvement of extraocular muscles was performed in two patients (1.7%). Overall, rehabilitative surgical treatment was planned in 31 patients (26.9%) with inactive disease. Two patients experienced reactivation of the disease. CONCLUSION: Despite the fact that paediatric and adult GO are considered two separate entities, they might be the same disease with two different clinical phenotypes. Paediatric GO population presents with a comparable clinical picture regarding both soft tissue involvement and proptosis, which may require surgical intervention. Proptosis was present in the majority of paediatric GO patients. Orbital decompression was performed in 21.7% of patients.
Authors 9
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Amsterdam University Medical Centers · University of Amsterdam
Affiliation as printed
Department of Ophthalmology Orbital Center Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
Department of Ophthalmology, Orbital Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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Emma Kinderziekenhuis · Amsterdam University Medical Centers · University of Amsterdam
Affiliation as printed
Department of Pediatric Endocrinology Emma Children’s Hospital Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
Department of Pediatric Endocrinology, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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Erasmus MC · Rotterdam Eye Hospital
Affiliation as printed
Orbital Center Rotterdam (The Rotterdam Eye Hospital & Erasmus Medical Center Rotterdam) Rotterdam The Netherlands
Orbital Center Rotterdam (The Rotterdam Eye Hospital & Erasmus Medical Center Rotterdam) Rotterdam The Netherlands
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Amsterdam Public Health · Amsterdam University Medical Centers · University of Amsterdam
Affiliation as printed
Department of Clinical Epidemiology, Biostatistics and Bioinformatics Amsterdam Public Health Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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Emma Kinderziekenhuis · Amsterdam University Medical Centers · University of Amsterdam
Affiliation as printed
Department of Pediatric Endocrinology Emma Children’s Hospital Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
Department of Pediatric Endocrinology, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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Amsterdam University Medical Centers · University of Amsterdam
Affiliation as printed
Department of Ophthalmology Orbital Center Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
Department of Ophthalmology, Orbital Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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University Medical Center Utrecht
Affiliation as printed
Department of Ophthalmology University Medical Center Utrecht Utrecht The Netherlands
Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
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Farabi Hospital · Tehran University of Medical Sciences
Affiliation as printed
Ophthalmic Plastic and Reconstructive Surgery Department Farabi Hospital Tehran University of Medical Sciences Tehran Iran
Ophthalmic Plastic and Reconstructive Surgery Department, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Peerooz Saeed corresponding
Amsterdam University Medical Centers · University of Amsterdam
Affiliation as printed
Department of Ophthalmology Orbital Center Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
Department of Ophthalmology, Orbital Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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