Correlation of clinical parameters and objective assessment tools in active thyroid eye disease – Prospective analytical study

Abstract

Primary objective of this study was to identify the disease in active phase, clinically assess it and start medical management. Secondary objective was to analyze whether the objective tools like B-scan and serum levels of IL-6 and HS-CRP aid in the diagnosis of activity in thyroid eye disease. : The aim wasto analyze the correlation of clinical parameters and significance of objective assessment tools in active thyroid eye disease. Clinically diagnosed cases of TED with lid signs, soft tissue changes, restrictive myopathy and bilateral axial proptosis were included in our study. Patients in chronic stable phase were excluded from study. This was a prospective analytical study, conducted from June 2010 till June 2012. Sample size was thirty patients in the age group of 20 to 60 years. Complete ophthalmology workup and objective disease assessment tools including B scan (OTI 1000 with 7.5-10 MHz) was used in our study. All patients underwent CT scan orbit-axial and coronal view. After assessing the severity and stage of the disease, each patient was managed accordingly using different modalities. : Identifying the disease activity early and aggressive management with systemic steroids in moderately active and severe stage has decreased the morbidity associated with the disease. A- scan with orbital B-scan helps in diagnosing the activity in thyroid eye disease. This procedure is very economical with relatively short examination time and no risk of radiation .Follow up of the patients can also be performed easily. IL-6 and HS-CRP was statistically significantly elevated in patients with severe disease when compared to control group. Hence can help in assessing disease activity in patients with severe disease.