2 mm difference) was seen in 45% of men and 23% of women (P=0.036). Overall asymmetry was seen in 55% of men and 19% of women (P=0.017). Thyroid status and sex had a combined effect on symmetry, as 15 of 16 hyperthyroid females (94%) demonstrated symmetric disease. Average NO SPECS severity was 3.5 (standard deviation [SD] 1.4) in men and 3.3 (SD 1.1) in women (P=0.51), and was 3.8 (SD 1.4) in asymmetric patients versus 3.2 (SD 1.3) in symmetric patients (P=0.08). The CAS was higher in asymmetric than symmetric patients (1.84 versus 0.97; P=0.012).CONCLUSION: Men demonstrated more asymmetric disease (proptosis and overall asymmetry) than women, while hyperthyroid females demonstrated more symmetry than euthyroid and hypothyroid males and females. NO SPECS severity score was unaffected by sex, thyroid status, or symmetry. Asymmetric patients demonstrated higher clinical activity scores." />
Display options
Share it on

Clin Ophthalmol. 2014 Jul 10;8:1295-300. doi: 10.2147/OPTH.S61041. eCollection 2014.

The relationship between sex and symmetry in thyroid eye disease.

Clinical ophthalmology (Auckland, N.Z.)

Shaheen C Kavoussi, Joseph N Giacometti, J Javier Servat, Flora Levin

Affiliations

  1. Department of Ophthalmology and Visual Science, Yale University, New Haven, CT, USA.
  2. Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA.

PMID: 25031528 PMCID: PMC4096447 DOI: 10.2147/OPTH.S61041

Abstract

PURPOSE: To examine the relationships between sex and symmetry in the context of disease activity, severity, and thyroid status in thyroid eye disease.

METHODS: Retrospective chart review of 31 men and 31 women with untreated thyroid eye disease. Subjective complaints, smoking status, thyroid status, and objective findings pertinent to the clinical activity score (CAS) and "NO SPECS" classification were recorded. Overall disease asymmetry was defined as having simultaneous asymmetry of both more than one symptom and more than one external finding. Asymmetry was compared across sex and thyroid status. CAS and NO SPECS severity were compared across sex, symmetry, and thyroid status.

RESULTS: Asymmetric appearance was reported by 58% of men and 19% of women. Asymmetric proptosis (>2 mm difference) was seen in 45% of men and 23% of women (P=0.036). Overall asymmetry was seen in 55% of men and 19% of women (P=0.017). Thyroid status and sex had a combined effect on symmetry, as 15 of 16 hyperthyroid females (94%) demonstrated symmetric disease. Average NO SPECS severity was 3.5 (standard deviation [SD] 1.4) in men and 3.3 (SD 1.1) in women (P=0.51), and was 3.8 (SD 1.4) in asymmetric patients versus 3.2 (SD 1.3) in symmetric patients (P=0.08). The CAS was higher in asymmetric than symmetric patients (1.84 versus 0.97; P=0.012).

CONCLUSION: Men demonstrated more asymmetric disease (proptosis and overall asymmetry) than women, while hyperthyroid females demonstrated more symmetry than euthyroid and hypothyroid males and females. NO SPECS severity score was unaffected by sex, thyroid status, or symmetry. Asymmetric patients demonstrated higher clinical activity scores.

Keywords: Graves’ ophthalmopathy; NO SPECS; clinical activity score; thyroid status

References

  1. Br J Ophthalmol. 2009 Aug;93(8):1052-6 - PubMed
  2. Ophthalmic Plast Reconstr Surg. 2004 May;20(3):224-5 - PubMed
  3. BMJ. 2001 Nov 3;323(7320):1058-60 - PubMed
  4. J Clin Endocrinol Metab. 2000 Mar;85(3):1038-42 - PubMed
  5. Endocrinol Metab Clin North Am. 1997 Mar;26(1):189-218 - PubMed
  6. Eur J Intern Med. 2008 Nov;19(7):531-6 - PubMed
  7. Am J Ophthalmol. 1996 Apr;121(4):426-34 - PubMed
  8. Clin Endocrinol (Oxf). 1997 Jul;47(1):9-14 - PubMed
  9. J Clin Endocrinol Metab. 2006 Dec;91(12):4873-80 - PubMed
  10. J Clin Endocrinol Metab. 1998 Mar;83(3):998-1002 - PubMed
  11. BMJ. 2009 Mar 06;338:b560 - PubMed
  12. Clin Endocrinol (Oxf). 1995 Jul;43(1):55-68 - PubMed
  13. Ophthalmology. 2004 May;111(5):997-1008 - PubMed
  14. Eye (Lond). 2012 Sep;26(9):1263-9 - PubMed
  15. Am J Ophthalmol. 1996 Mar;121(3):284-90 - PubMed
  16. Arch Ophthalmol. 1993 Feb;111(2):197-201 - PubMed
  17. Clin Endocrinol (Oxf). 1993 Apr;38(4):367-72 - PubMed
  18. J Clin Endocrinol Metab. 1977 Jan;44(1):203-4 - PubMed
  19. Am J Ophthalmol. 1995 Oct;120(4):511-7 - PubMed
  20. Endocr Rev. 2000 Apr;21(2):168-99 - PubMed

Publication Types