Thyroid Research Thyroid Research Archive Graves’ Ophthalmopathy

Long-term impairment in vision and quality of life in patients with Graves' eye disease

(November 2002)

The background of the study. Patients with Graves' eye disease may have persistent changes in the appearance and function of their eyes. These changes may lead to long-term psychological problems and limitations in activities. The long-term effects of Graves' eye disease on quality of life and on visual function was studied.

How the study was done. The major study group consisted of patients with Graves' eye disease who had been treated with external-beam radiation, prednisone, or both, 10 to 20 years earlier. Other study groups were patients with Graves' eye disease studied at the time of radiation therapy or eye surgery, and normal subjects. The study subjects completed one or more of several questionnaires relating to quality of life, and the patients with eye disease also completed a quality-of-life questionnaire specifically related to eye disease and were evaluated by an ophthalmologist.

The results of the study. There were 168 patients in the previously treated group and 206 patients in the group being treated when studied. Both groups scored lower than the normal subjects on several components of the general quality-of-life questionnaire, and the scores on the Graves' eye disease quality of life questionnaire were lower in the patients being treated than in those previously treated.

In the group of previously treated patients, those who were nonsmokers had higher scores on the Graves' eye disease quality-of-life score than did smokers. Patients treated with radiation tended to score lower on the general quality-of-life questionnaires. Patients considered to have responded to radiation or prednisone therapy with a decrease in soft-tissue changes, eye protrusion, and double vision, and an increase in visual acuity scored higher on both questionnaires.

The conclusions of the study. Patients with Graves' eye disease may have persistent impairment in the appearance and function of their eyes and a decreased quality of life.

The original article. Terwee C, Wakelkamp I, Tan S, Dekker F, Prummel MF, Wiersinga W. Long-term effects of Graves' ophthalmopathy on health-related quality of life. Eur J Endocrinol 2002;146:751-7.