Prevalence and clinical characterstics of thyroid eye disease among goiter patients attended jimma university medical center surgical referral clinic, jimma, Ethiopia

Abstract

Background: - Graves’ disease is a common autoimmune endocrine disorder characterized by thyroid hyperplasia and excessive thyroid hormone production. Thyroid eye disease results from infiltration of the orbit by auto-reactive T-lymphocytes, proliferation of orbital fibroblasts and increased orbital fat, leading to its clinical features. But the studies done on the prevalence and associated clinical features of TED are so limited. Objective: - The main objective of the study was to assess the prevalence of TED and clinical characterstics of TED among goiter patients seen JUMC surgical referral clinic from April to July, 2018. Methods: - Institution based cross-sectional study was carried out among 211 patients seen in JUMC surgical referral clinic from April – July 2018. Patients selected using systematic random sampling technique and structured questionnaire was used to collect data. The collected data was coded and entered into Epi data version 3.1 and analyzed using SPSS version 20. Descriptive and bivariate analyses were done and all variables having a p-value of less than 0.25 were selected for multivariable analyses. Multivariable logistic regression models were used to isolate independent predictors of Thyroid eye disease. Data was presented using tables and graphs. Results: - Out of 211 goiter patients seen at Jimma university medical center surgical referral clinic over the 3 month study period; 27% of them were found to have thyroid eye disease. Regarding the ocular symptoms, tearing was the leading compliant of the patients followed by gritting sensation, double vision and eye pain. Among the signs of thyroid eye disease observed; lid retraction was the most frequently observed while proptosis was found only in one case and there was no exposure kerathopathy or dysthyroid optic neuropathy found. The factors that had statistically significant association with the prevalence of thyroid eye disease were thyroid dysfunction (AOR=2.781, [95% CI 1.362, 5.678] P=0.005), smoking (AOR = 6.391, [95% CI 1.868, 21.860] P = 0.003), high blood pressure (AOR = 2.062, 95% CI 1.001 – 4.251] P = 0.050) and pulse rate (AOR=2.277[95% CI 1.003, 5.167] P=0.049). Conclusion and recommendations: - Thyroid eye disease among goiter patients is common and there are many patients having follow up for goiter. So, we have to educate the patients and the physicians to link them to ophthalmology for detail eye examination.