Diagnostic approaches in a series of cases with Graves ophthalmopathy

Abstract

Introduction. The definition of severity and activity of Graves' ophthalmopathy (GO) comprises different parameters. The aim of this study is to select the most appropriate severity and activity criteria, respectively scores and to investigate a possible correlation among them. Subjects and methods. The study included 51 patients with GO (43 females, 8 males), mean age 46.8±11.2 years. The patients were evaluated by: clinical exam, laboratory parameters (TSH, FT4, FT3, thyroid autoantibodies) and imagistic means, performed in selected cases (CT or MRI). Results. The GO activity was assessed by the clinical activity score (CAS). We quantified the EUGOGO severity criteria, by allotting points for each selected parameter. According to the recommended criteria, the cases were divided into active (n=26) and inactive forms (n=25). There were no significant statistical differences regarding CAS between euthyroid cases (n=14) and dysthyroid cases (n=37). Serum thyroid receptor antibodies (TRAb) levels did not correlate with CAS or severity scores. Severity scores correlated significantly with CAS (Pearson correlation index 0.546, r2=0.290, p=0.0001). Conclusion. Active forms of GO showed higher severity scores than the inactive ones. The severity scores correlated significantly with CAS scores. Neither CAS, nor severity scores correlated significantly with the severity of thyrotoxicosis.