Journal List > J Korean Ophthalmol Soc > v.57(10) > 1010414

Huh and Lee: Change in Quality of Life after Orbital Decompression Surgery in Patients with Dysthyroid Ophthalmopathy

Abstract

Purpose

To evaluate the effect of orbital decompression surgery on quality of life in thyroid-associated ophthalmopathy (TAO) patients.

Methods

From August 2014 to December 2015, 80 patients diagnosed with TAO at our clinic were retrospectively analyzed. The patients were divided into 2 groups: 30 patients who underwent orbital decompression surgery and 50 patients who did not receive surgery. The Korean version of the Grave's ophthalmopathy specific quality of life (GO-QoL) questionnaire was completed by all patients. We compared questionnaire scores between groups and analyzed demographic and clinical factors affecting change in GO-QoL.

Results

The patients who underwent orbital decompression had lower mean GO-QoL score for appearance in comparison with patients without orbital decompression (p < 0.001). The mean GO-QoL score for appearance was increased from 28.8 ± 17.1 to 51.5 ± 18.8 after orbital decompression (p = 0.024). The mean GO-QoL score for visual function was not different between the patients who did not receive surgery and the orbital decompression group. The mean GO-QoL score for visual function was not changed after orbital decompression. There was a significant relation between postoperative proptosis degree and change in GO-QoL score for appearance after orbital decompression.

Conclusions

GO-QoL score for appearance was significantly improved after orbital decompression surgery, and psychological interventions should be considered to enhance the quality of life outcomes.

References

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Figure 1.
Grave's ophthalmopathy specific quality of life (GO-QoL) scores for visual function and appearance. There was no significance difference in GO-QoL score for visual function between each groups. The patients who underwent orbital decompression had lower mean GO-QoL score for appearance in comparison with patients without orbital decompression (* p < 0.001). The mean GO-QoL score for appearance was increased after orbital decompression ( p = 0.024).
jkos-57-1514f1.tif
Table 1.
Characteristic of study population
  No-surgery group Decompression group p-value
Number 50 30  
Sex (male/female) 18/32 12/18 0.721*
Age (years) 34.7 ± 12.4 (16–63) 33.8 ± 11.0 (18–60) 0.693
Family history of thyroid disease (n, %) 17 (34) 13 (43.3) 0.944*
Smoker (n, %) 9 (18) 4 (13.3) 0.757
Duration of eye symptoms (months) 34.5 ± 40.5 (6–144) 41.9 ± 56.5 (10–180) 0.207
Clinical activity score 2.2 ± 1.1 2.5 ± 1.1 0.177
Exophthalmos 18.8 ± 2.2 19.8 ± 2.5 0.521
Compression neuropathy (n, %) 5 (10) 2 (6.7) 0.706

Values are presented as mean ± standard deviation.

* Chi-square test

Fisher's exact test

Unpaired t-test.

Table 2.
Factors associated with changes in quality of life (QoL) parameter after orbital decompression
    Age Duration CAS Pre-op Exo Exo change Post-op Exo
Visual score Pearson coefficient –0.036 0.190 0.068 –0.048 0.195 –0.092
  p-value 0.850 0.565 0.721 0.800 0.301 0.629
Appearance score Pearson coefficient 0.019 0.372 0.123 –0.095 0.169 –0.423
  p-value 0.922 0.067 0.081 0.617 0.372 0.020
Total QoL score Pearson coefficient –0.017 0.031 0.120 0.169 0.242 –0.304
  p-value 0.929 0.782 0.529 0.372 0.197 0.102

CAS = clinical activity score; Pre-op = preoperative; Post-op = postoperative; Exo = exophthalmometer.

Table 3.
Frequencies of responses from Grave's ophthalmopathy specific quality of life (GO-QoL) questionnaire
  Yes, severely limited (%)
Yes, a little limited (%)
No, not at all limited (%)
Follow up Decompression
Follow up Decompression
Follow up Decompression
Before After Before After Before After
Visual
   Riding a bicycle 4 6.7 6.7 16 26.7 20.0 58 33.3 40.0
   Driving 6 6.7 6.7 24 23.3 23.3 28 23.3 23.3
   Moving around the house 4 3.3 3.3 6 36.7 26.7 90 60.0 70.0
   Walking outdoors 6 6.7 6.7 24 36.7 36.7 70 56.7 56.7
   Reading 8 6.7 16.7 40 56.7 36.7 52 36.7 46.7
   Watching TV 4 3.3 6.7 34 46.7 43.3 62 50.0 50.0
   Hobbies or pastimes 6 3.3 10.0 36 53.3 43.3 58 43.3 46.7
   Hindered from doing something 6 16.7 6.7 70 63.3 63.3 24 20.0 30.0
Appearance
   Changed appearance 84 76.7 53.3 16 23.3 40.0 0 0.0 6.7
   Stared in the streets 18 46.7 23.3 54 50.0 53.3 28 3.3 23.3
   People react unpleasantly 4 30.0 3.3 46 56.7 70.0 50 13.3 26.7
   Influence on self confidence 40 66.7 30.0 48 33.3 53.3 12 0.0 16.7
   Socially isolated 2 16.7 6.7 30 56.7 46.7 68 26.7 46.7
   Influence on making friends 20 46.7 10.0 40 40.0 56.7 40 13.3 33.3
   Appear less on photos 54 70.0 23.3 36 26.7 50.0 10 3.3 26.7
   Mask changes of appearance 40 63.3 33.3 38 26.7 43.3 22 10.0 23.3
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