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Prevalence of increased intraocular pressure in patients with Graves’ ophthalmopathy and association with ophthalmic signs and symptoms in the north-west of Iran

Authors Eslami F, Borzouei S, Khanlarzadeh E, Seif S

Received 13 February 2019

Accepted for publication 17 June 2019

Published 25 July 2019 Volume 2019:13 Pages 1353—1359


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Fatemeh Eslami,1 Shiva Borzouei,2 Elham Khanlarzadeh,3 Shiva Seif3

1Department of Ophthalmology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; 2Clinical Research Development Unit of Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, Iran; 3School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

Introduction: Graves’ ophthalmopathy (GO) is the most common extra-thyroidal manifestation of Graves’ disease and is characterized by multiple ocular symptoms such as eyelid retraction, lid lag, proptosis, elevated intraocular pressure (IOP) and ultimately loss of vision. We aimed to investigate the prevalence of increased IOP in Graves’ patients and association with ophthalmic signs and symptoms in north-west of Iran.
Materials and methods: This descriptive cross-sectional study recruited 93 patients with GO who were diagnosed based on clinical and laboratory examinations. A complete ocular examination and IOP measurements on forward gaze were performed using Goldman applanation tonometer.
Results: In this study, 93 patients with GO were evaluated from 2016 to 2017. Among these patients, 67 (72.05%) were female and 27 (27.95%) were male. The most common complaints of patients were lid retraction (62.36%), puffy eyelids (58.06%) and proptosis (46.23%), respectively. The duration of disease was 0–24 months in most patients. Most subjects were at grade 3 according to NOSPECS classification. Nine patients (9.6%) had an IOP greater than or equal to 21 mmHg. The mean IOP in subjects was 16.61±3.42 mmHg. The mean IOP in males and smokers was significantly higher than that of females and nonsmokers. The mean IOP increased significantly with a higher grade of disease, duration of disease, age and smoking.
Conclusions: According to the results, females comprised the majority of the study population, while ocular complications were more prevalent among males. The highest IOP was seen in old cases of GO. The most prevalent ocular signs in patients were eyelid retraction and periorbital edema. The least prevalent sign was glaucomatous optic neuropathy. In this study, the prevalence of intra-ocular hypertension was higher than that of the general population, especially in males, old cases with a drug history of antithyroid medication and smokers.

Keywords: Graves’ ophthalmopathy, intra ocular pressure

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