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Prevalence of Ocular Hypertension and Glaucoma as Well as Associated Factors in Graves' Orbitopathy

Kim, Ji, Won, MD*,†; Ko, JaeSang, MD*; Woo, Young, Jun, MD*,‡; Bae, Hyoung, Won, MD*; Yoon, Jin, Sook, MD, PhD*

doi: 10.1097/IJG.0000000000000942
Original Studies

Purpose: The purpose of this study was to determine the prevalence of ocular hypertension (OHT) and open-angle glaucoma (OAG) in patients with Graves' orbitopathy (GO) and to investigate the associations between clinical features of the disease and the prevalence of OHT and OAG.

Methods: A cross-sectional analytic study was conducted among a total of 1128 patients with GO. A complete ophthalmic examination was performed, including intraocular pressure, optic disc photography, visual field testing using a Humphrey visual field analyzer, and retinal nerve fiber layer thickness measured by optical coherence tomography. The results were analyzed by univariate and multivariate logistic regression.

Results: A 6.8% prevalence of OHT (77/1128) and a 1.6% prevalence of OAG (18/1128) were observed. When considering only patients older than 40 years, the prevalence of OHT and OAG was 9.5% and 3.4%, respectively. Twenty-nine of the 1128 patients (2.6%) developed compressive optic neuropathy. Of the factors evaluated, male sex [odds ratio (OR), 1.83; 95% confidence interval (CI), 1.08-3.10], duration of GO (6 to 24 mo; OR, 2.08; 95% CI, 1.17-3.71; 24 to 60 mo; OR, 3.45; 95% CI, 1.66-7.18), clinical activity score ≥3 (OR, 1.76; 95% CI, 1.03-3.01), extraocular muscle involvement (OR, 4.65; 95% CI, 2.54-8.50), and lid retraction (OR, 2.17; 95% CI, 1.19-3.96) were associated with the prevalence of OHT in GO. The prevalence of OAG was associated with male sex (OR, 4.29; 95% CI, 1.60-11.51) and duration of GO (≥60 mo; OR, 4.28; 95% CI, 1.11-16.47).

Conclusions: The prevalence of OHT in patients with GO was higher and the prevalence of OAG was similar to that in the general population.

*Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul

Yonsei Plus Eye Center, Seoungnam

Yonsei Bom Eye Clinic, Hanam, Korea

Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (NRF-2017R1A2B4009565).

J.W.K. and J.S.Y.: conception and design. J.W.K., Y.J.W., and H.W.B.: acquisition of data. J.W.K., J.K., H.W.B., and J.S.Y.: analysis and interpretation of data. All authors: drafting the article and revising it critically for important intellectual content; and final approval of the version to be published.

Disclosure: The authors declare no conflict of interest.

Reprints: Jin Sook Yoon, MD, PhD, Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea (e-mail:

Received October 15, 2017

Accepted March 8, 2018

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