ArticleJournal of endocrinological investigation2020
Asymmetry indicates more severe and active disease in Graves' orbitopathy: results from a prospective cross-sectional multicentre study.
Article in Journal of endocrinological investigation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 34 citations in OpenAlex.
- Improvement of asymmetric thyroid eye disease with teprotumumab.The British journal of ophthalmology · 2022Trial
- Visual outcomes in thyroid-associated ophthalmopathy with no light perception.Eye (London, England) · 2026Article
- Differences in autoimmune thyroid diseases between females and males: the result of a complex interconnection of factors.Endocrine · 2025Review
- Orbital Radiotherapy for Graves' Ophthalmopathy: Single Institutional Experience of Efficacy and Safety.Diseases (Basel, Switzerland) · 2025Article
- Study on the correlation between serum IgG4/IgG levels and the development of Graves' ophthalmopathy.Scientific reports · 2025Article
- Lacrimal gland enlargement in thyroid eye disease.International ophthalmology · 2024Article
- Unilateral Graves' Orbitopathy in a Patient with Marine-Lenhart Syndrome: A case report.Sultan Qaboos University medical journal · 2024Article
- Correlation between extraocular muscle enlargement and thyroid autoantibodies in thyroid eye disease.Japanese journal of ophthalmology · 2024Article
- Asymmetric proptosis in thyroid eye disease.International ophthalmology · 2024Article
- Age and gender influence on clinical manifestations of thyroid-associated ophthalmopathy: a case series of 2479 Chinese patients.Frontiers in endocrinology · 2024Article
- A comparison between bilateral and unilateral thyroid eye disease.International ophthalmology · 2023Article
- Risk factors for development of superior limbic keratoconjunctivitis in thyroid eye disease in Japanese.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2023Observational
- Article
- Teprotumumab and the Evolving Therapeutic Landscape in Thyroid Eye Disease.The Journal of clinical endocrinology and metabolism · 2022Review
- 3-D cephalometry of the the orbit regarding endocrine orbitopathy, exophthalmos, and sex.PloS one · 2022Article
- Changes in Eyelid Pressure and Dry Eye Status after Orbital Decompression in Thyroid Eye Disease.Journal of clinical medicine · 2021Article
- Comics' representation of Graves' orbitopathy, by Emil Ferris.Journal of endocrinological investigation · 2021Article
- Thyrotropin receptor antibodies and Graves' orbitopathy.Journal of endocrinological investigation · 2021Review
- Tear film break-up patterns in thyroid eye disease.Scientific reports · 2021Observational
- Epidemiology, Natural History, Risk Factors, and Prevention of Graves' Orbitopathy.Frontiers in endocrinology · 2020Review
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Authors and funding
40 authors at 16 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePatients with Graves' orbitopathy can present with asymmetric disease. The aim of this study was to identify clinical characteristics that distinguish asymmetric from unilateral and symmetric Graves' orbitopathy.
methodsThis was a multi-centre study of new referrals to 13 European Group on Graves' Orbitopathy (EUGOGO) tertiary centres. New patients presenting over a 4 month period with a diagnosis of Graves' orbitopathy were included. Patient demographics were collected and a clinical examination was performed based on a previously published protocol. Patients were categorized as having asymmetric, symmetric, and unilateral Graves' orbitopathy. The distribution of clinical characteristics among the three groups was documented.
resultsThe asymmetric group (n = 83), was older than the symmetric (n = 157) group [mean age 50.9 years (SD 13.9) vs 45.8 (SD 13.5), p = 0.019], had a lower female to male ratio than the symmetric and unilateral (n = 29) groups (1.6 vs 5.0 vs 8.7, p < 0.001), had more active disease than the symmetric and unilateral groups [mean linical Activity Score 3.0 (SD 1.6) vs 1.7 (SD 1.7), p < 0.001 vs 1.3 (SD 1.4), p < 0.001] and significantly more severe disease than the symmetric and unilateral groups, as measured by the Total Eye Score [mean 8.8 (SD 6.6) vs 5.3 (SD 4.4), p < 0.001, vs 2.7 (SD 2.1), p < 0.001].
conclusionOlder age, lower female to male ratio, more severe, and more active disease cluster around asymmetric Graves' orbitopathy. Asymmetry appears to be a marker of more severe and more active disease than other presentations. This simple clinical parameter present at first presentation to tertiary centres may be valuable to clinicians who manage such patients.
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