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PREGO (presentation of Graves’ orbitopathy) study: changes in referral patterns to European Group On Graves’ Orbitopathy (EUGOGO) centres over the period from 2000 to 2012
  1. Petros Perros1,
  2. Miloš Žarković2,
  3. Claudio Azzolini3,
  4. Göksun Ayvaz4,
  5. Lelio Baldeschi5,
  6. Luigi Bartalena6,
  7. Antonella Boschi5,
  8. Claire Bournaud7,
  9. Thomas Heiberg Brix8,
  10. Danila Covelli9,
  11. Slavica Ćirić2,
  12. Chantal Daumerie10,
  13. Anja Eckstein11,
  14. Nicole Fichter12,
  15. Dagmar Führer13,
  16. Laszlo Hegedüs8,
  17. George J Kahaly14,
  18. Onur Konuk15,
  19. Jürg Lareida12,
  20. John Lazarus16,
  21. Marenza Leo17,
  22. Lemonia Mathiopoulou18,
  23. Francesca Menconi17,
  24. Daniel Morris19,
  25. Onyebuchi Okosieme16,
  26. Jaques Orgiazzi20,
  27. Susanne Pitz21,
  28. Mario Salvi9,
  29. Cristina Vardanian-Vartin22,
  30. Wilmar Wiersinga23,
  31. Martine Bernard24,
  32. Lucy Clarke25,
  33. Nicola Currò26,
  34. Colin Dayan16,
  35. Jane Dickinson25,
  36. Miroslav Knežević27,
  37. Carol Lane19,
  38. Claudio Marcocci17,
  39. Michele Marinò17,
  40. Lars Möller13,
  41. Marco Nardi28,
  42. Christopher Neoh25,
  43. Simon Pearce1,
  44. George von Arx12,
  45. Fosun Baloş Törüner4
  1. 1Department of Endocrinology, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
  2. 2Department of Endocrinology, School of Medicine, University of Belgrade, Belgrade, Serbia
  3. 3Department of Surgical and Morphological Sciences, Section of Ophthalmology, School of Medicine, University of Insubria, Varese, Italy
  4. 4Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey
  5. 5Department of Ophthalmology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
  6. 6Endocrine Unit, Ospedale di Circolo, University of Insubria, Varese, Italy
  7. 7Department of Endocrinology and Nuclear Medicine, GHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, France
  8. 8Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
  9. 9Graves’ Orbitopathy Unit, Department of Clinical Sciences and Community Health, Fondazione Ca'Granda IRCCS, University of Milan, Milan, Italy
  10. 10Department of Endocrinology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
  11. 11Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany
  12. 12Department of Ophthalmology, Interdisciplinary Centre for Graves’ Orbitopathy, Olten, Switzerland
  13. 13Department of Endocrinology and Metabolism, University of Duisburg-Essen, Essen, Germany
  14. 14Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany
  15. 15Department of Ophthalmology, Faculty of Medicine, Gazi University, Ankara, Turkey
  16. 16Department of Endocrinology, Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK
  17. 17Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
  18. 18Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  19. 19Cardiff Eye Unit, University Hospital of Wales, Cardiff, UK
  20. 20Department of Endocrinology, Centre Hospitalier Lyon-Sud, Lyon, France
  21. 21Department of Ophthalmology, Johannes Gutenberg University Medical Center, Mainz, Germany
  22. 22Unité de Neuro-ophtalmologie, Hôpital Neurologique, Hospices Civils de Lyon, Lyon, France
  23. 23Department of Endocrinology, Academic Medical Center, Amsterdam, The Netherlands
  24. 24Neuro-Ophthalmology Outpatient Clinics, GHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, France
  25. 25Department of Ophthalmology, Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  26. 26Department of Ophthalmology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
  27. 27Department of Ophthalmology, Medical School, Clinic for Ophthalmology, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
  28. 28Dipartimento di Patologia Chirurgica Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
  1. Correspondence to Dr Petros Perros, Department of Endocrinology, Elliott Building, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK; petros.perros{at}ncl.ac.uk

Abstract

Background/aims The epidemiology of Graves’ orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time.

Methods Prospective observational study of European Group On Graves’ Orbitopathy (EUGOGO) centres. All new referrals with a diagnosis of GO over a 4-month period in 2012 were included. Clinical and demographic characteristics, referral timelines and initial decisions about management were recorded. The data were compared with a similar EUGOGO survey performed in 2000.

Results The demographic characteristics of 269 patients studied in 2012 were similar to those collected in the year 2000, including smoking rates (40.0% vs 40.2%). Mild (60.5% vs 41.2%, p<0.01) and inactive GO (63.2% vs 39.9%, p<0.01) were more prevalent in 2012. The times from diagnosis of thyroid disease to being seen in EUGOGO centres (6 vs 16 months) and from first symptoms of GO (9 vs 16 months) or from diagnosis of GO (6 vs 12 months) to first consultation in EUGOGO centres were shorter in 2012 (p<0.01). The initial management plans for GO were no different except surgical treatments for patients with mild inactive disease were more frequently offered in the 2012 cohort than in 2000 (27.3% vs 17%, p<0.05), and selenium supplements were offered only in the 2012 cohort (21.2% vs 0%, p<0.01).

Conclusions These findings suggest that the clinical manifestations of patients with GO may be changing over time in Europe.

  • Orbit
  • Epidemiology
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