The association of race with thyroid eye disease presentation and outcomes
IntroductionClassification of thyroid eye disease (TED) is largely based on guidelines developed in Europe and North America. Few studies have investigated the presentation and treatment of TED in Black populations. The objective is to examine the manifestations of TED in secondary and tertiary care...
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Ophthalmology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fopht.2023.1309850/full |
| _version_ | 1827159911100841984 |
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| author | Diane Wang Diane Wang Diane Wang Charlotte Marous Charlotte Marous Charlotte Marous Pelin Celiker Wenyu Deng Wenyu Deng Eva Kristoferson Ali Elsayed Roman Shinder Roman Shinder Roman Shinder Nickisa Hodgson Nickisa Hodgson |
| author_facet | Diane Wang Diane Wang Diane Wang Charlotte Marous Charlotte Marous Charlotte Marous Pelin Celiker Wenyu Deng Wenyu Deng Eva Kristoferson Ali Elsayed Roman Shinder Roman Shinder Roman Shinder Nickisa Hodgson Nickisa Hodgson |
| author_sort | Diane Wang |
| collection | DOAJ |
| description | IntroductionClassification of thyroid eye disease (TED) is largely based on guidelines developed in Europe and North America. Few studies have investigated the presentation and treatment of TED in Black populations. The objective is to examine the manifestations of TED in secondary and tertiary care center-based populations with a significant proportion of Black patients.Materials and methodsRetrospective chart review identifying patients with a reported race/ethnicity and a presenting clinical diagnosis of TED at Kings County Hospital and SUNY Downstate Medical Center and affiliated clinics from January 1, 2010 through July 31, 2021. Main outcome measures include age of disease onset, sex, smoking status, insurance status, postal code of residence, clinical exam features, number of follow-up visits, length of follow-up, and treatments received.ResultsOf the 80 patients analyzed, 49 were Black (61.2%) and 31 were White (38.8%). Between Black and White patients, there were differences in the mean age of presentation (48.1 [range 21-76] vs 56.8 [range 28-87] years, P=0.03), insurance status (51.0% vs 77.4% private insurance, P=0.02), and mean follow up length among those with multiple visits (21.6 [range 2-88] vs 9.7 [range 1-48] months, P=0.02). The distribution of EUGOGO scores were not significantly different between Black and White patients. On initial presentation, fewer Black patients had chemosis (OR 0.21, 95% CI, 0.08 to 0.57, P=0.002), and caruncular swelling (OR 0.19, 95% CI, 0.06 to 0.59, P=0.002) compared to White patients. During the overall disease course, fewer Black patients had subjective diplopia (OR 0.20, 95% CI, 0.07 to 0.56, P=0.002), chemosis (OR 0.24, 95% CI, 0.09 to 0.63, P=0.004), and caruncular swelling (OR 0.18, 95% CI, 0.07 to 0.51, P=0.001) compared to White patients. Black patients received oral steroids (42.9% vs 67.7%, P=0.03), intravenous steroids (18.4% vs 16.1%, P=0.8), orbital decompression surgery (16.7% vs 6.5%, P=0.19), and teprotumumab (22.9% vs 22.6%, P=0.99) at similar rates.DiscussionBlack patients presented with fewer external exam findings suggestive of active TED compared to White patients, but the rate of compressive optic neuropathy and decompression surgery were similar in the two groups. These differences may be due to disease phenotypes, which warrant further study. |
| first_indexed | 2024-03-08T12:08:12Z |
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| issn | 2674-0826 |
| language | English |
| last_indexed | 2025-03-21T00:04:39Z |
| publishDate | 2024-01-01 |
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| series | Frontiers in Ophthalmology |
| spelling | doaj.art-ec9a2866d24f484bbe1e8a0e10f05b6d2024-08-03T11:01:18ZengFrontiers Media S.A.Frontiers in Ophthalmology2674-08262024-01-01310.3389/fopht.2023.13098501309850The association of race with thyroid eye disease presentation and outcomesDiane Wang0Diane Wang1Diane Wang2Charlotte Marous3Charlotte Marous4Charlotte Marous5Pelin Celiker6Wenyu Deng7Wenyu Deng8Eva Kristoferson9Ali Elsayed10Roman Shinder11Roman Shinder12Roman Shinder13Nickisa Hodgson14Nickisa Hodgson15Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, Kings County Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, West Virginia University, Morgantown, WV, United StatesDepartment of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, Kings County Medical Center, Brooklyn, NY, United StatesOculoplastic and Orbital Surgery, Wills Eye Hospital, Thomas Jefferson University Hospital, Philadelphia, PA, United StatesDepartment of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, Kings County Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, Kings County Medical Center, Brooklyn, NY, United StatesDepartment of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY, United StatesDepartment of Ophthalmology, Kings County Medical Center, Brooklyn, NY, United StatesIntroductionClassification of thyroid eye disease (TED) is largely based on guidelines developed in Europe and North America. Few studies have investigated the presentation and treatment of TED in Black populations. The objective is to examine the manifestations of TED in secondary and tertiary care center-based populations with a significant proportion of Black patients.Materials and methodsRetrospective chart review identifying patients with a reported race/ethnicity and a presenting clinical diagnosis of TED at Kings County Hospital and SUNY Downstate Medical Center and affiliated clinics from January 1, 2010 through July 31, 2021. Main outcome measures include age of disease onset, sex, smoking status, insurance status, postal code of residence, clinical exam features, number of follow-up visits, length of follow-up, and treatments received.ResultsOf the 80 patients analyzed, 49 were Black (61.2%) and 31 were White (38.8%). Between Black and White patients, there were differences in the mean age of presentation (48.1 [range 21-76] vs 56.8 [range 28-87] years, P=0.03), insurance status (51.0% vs 77.4% private insurance, P=0.02), and mean follow up length among those with multiple visits (21.6 [range 2-88] vs 9.7 [range 1-48] months, P=0.02). The distribution of EUGOGO scores were not significantly different between Black and White patients. On initial presentation, fewer Black patients had chemosis (OR 0.21, 95% CI, 0.08 to 0.57, P=0.002), and caruncular swelling (OR 0.19, 95% CI, 0.06 to 0.59, P=0.002) compared to White patients. During the overall disease course, fewer Black patients had subjective diplopia (OR 0.20, 95% CI, 0.07 to 0.56, P=0.002), chemosis (OR 0.24, 95% CI, 0.09 to 0.63, P=0.004), and caruncular swelling (OR 0.18, 95% CI, 0.07 to 0.51, P=0.001) compared to White patients. Black patients received oral steroids (42.9% vs 67.7%, P=0.03), intravenous steroids (18.4% vs 16.1%, P=0.8), orbital decompression surgery (16.7% vs 6.5%, P=0.19), and teprotumumab (22.9% vs 22.6%, P=0.99) at similar rates.DiscussionBlack patients presented with fewer external exam findings suggestive of active TED compared to White patients, but the rate of compressive optic neuropathy and decompression surgery were similar in the two groups. These differences may be due to disease phenotypes, which warrant further study.https://www.frontiersin.org/articles/10.3389/fopht.2023.1309850/fullthyroid eye disease (TED)orbitteprotumumabEUGOGOGraves’ disease |
| spellingShingle | Diane Wang Diane Wang Diane Wang Charlotte Marous Charlotte Marous Charlotte Marous Pelin Celiker Wenyu Deng Wenyu Deng Eva Kristoferson Ali Elsayed Roman Shinder Roman Shinder Roman Shinder Nickisa Hodgson Nickisa Hodgson The association of race with thyroid eye disease presentation and outcomes Frontiers in Ophthalmology thyroid eye disease (TED) orbit teprotumumab EUGOGO Graves’ disease |
| title | The association of race with thyroid eye disease presentation and outcomes |
| title_full | The association of race with thyroid eye disease presentation and outcomes |
| title_fullStr | The association of race with thyroid eye disease presentation and outcomes |
| title_full_unstemmed | The association of race with thyroid eye disease presentation and outcomes |
| title_short | The association of race with thyroid eye disease presentation and outcomes |
| title_sort | association of race with thyroid eye disease presentation and outcomes |
| topic | thyroid eye disease (TED) orbit teprotumumab EUGOGO Graves’ disease |
| url | https://www.frontiersin.org/articles/10.3389/fopht.2023.1309850/full |
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