TY - JOUR
T1 - Double vision is a major manifestation in moderate to severe Graves' orbitopathy, but It correlates negatively with inflammatory signs and proptosis
AU - Laurberg, Peter
AU - Berman, Dalia
AU - Pedersen, Inge Bülow
AU - Andersen, Stig
AU - Carlé, Allan
PY - 2015
Y1 - 2015
N2 - Context: Double vision (diplopia) is a major determinant of work disability in patients with Graves' orbitopathy (GO), but it is not part of the NOSPECS classification of GO. Objective: To quantitate diplopia in patients with moderate to severe GO, and to study associations with other disease and patient variables. Design: Single center prospective study of consecutive patients at the time of referral. Setting: University Hospital Thyroid-Eye-Clinic. Patients: 216 patients diagnosed with moderate to severe and active GO. Main Outcome Measures: Binocular diplopia in field of gaze, and monocular fields of motility were prospectively recorded on diagrams and measured by planimetry. Fields of diplopia were correlated to other disease and patient variables. Results: Six patients had only one functional eye and were excluded. Among the remaining 210 patients, diplopia was present in 75.2 %. In patients with diplopia this ranged from five to 100 % (observed in 11.4 % of patients) of binocular field of gaze. The field of diplopia correlated positively with eye motility restriction and with asymmetrical affection of orbits but negatively with signs of inflammation and proptosis that often are the main outcome measures in clinical studies of GO therapy. Conclusion: Diplopia is very common in moderate to severe GO and a major cause for active therapy. In moderate to severe GO the field of diplopia correlates negatively with some other indicators of disease activity, which may be explained by the physiological properties of binocular fusion.
AB - Context: Double vision (diplopia) is a major determinant of work disability in patients with Graves' orbitopathy (GO), but it is not part of the NOSPECS classification of GO. Objective: To quantitate diplopia in patients with moderate to severe GO, and to study associations with other disease and patient variables. Design: Single center prospective study of consecutive patients at the time of referral. Setting: University Hospital Thyroid-Eye-Clinic. Patients: 216 patients diagnosed with moderate to severe and active GO. Main Outcome Measures: Binocular diplopia in field of gaze, and monocular fields of motility were prospectively recorded on diagrams and measured by planimetry. Fields of diplopia were correlated to other disease and patient variables. Results: Six patients had only one functional eye and were excluded. Among the remaining 210 patients, diplopia was present in 75.2 %. In patients with diplopia this ranged from five to 100 % (observed in 11.4 % of patients) of binocular field of gaze. The field of diplopia correlated positively with eye motility restriction and with asymmetrical affection of orbits but negatively with signs of inflammation and proptosis that often are the main outcome measures in clinical studies of GO therapy. Conclusion: Diplopia is very common in moderate to severe GO and a major cause for active therapy. In moderate to severe GO the field of diplopia correlates negatively with some other indicators of disease activity, which may be explained by the physiological properties of binocular fusion.
U2 - 10.1210/jc.2014-4557
DO - 10.1210/jc.2014-4557
M3 - Journal article
C2 - 25695893
VL - 100
SP - 2098
EP - 2105
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 5
ER -