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

source: The British Journal of Ophthalmology

year: 2015

authors: Perros P, Žarković M, Azzolini C, Ayvaz G, Baldeschi L, Bartalena L, Boschi A, Bournaud C, Brix TH, Covelli D, Ćirić S, Daumerie C, Eckstein A, Fichter N, Führer D, Hegedüs L, Kahaly GJ, Konuk O, Lareida J, Lazarus J, Leo M, Mathiopoulou L, Menconi F, Morris D, Okosieme O, Orgiazzi J, Pitz S, Salvi M, Vardanian-Vartin C, Wiersinga W, Bernard M, Clarke L, Currò N, Dayan C, Dickinson J, Knežević M, Lane C, Marcocci C, Marinò M, Möller L, Nardi M, Neoh C, Pearce S, von Arx G, Törüner FB

summary/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.

organization: Newcastle University, UK; University of Belgrade, Serbia; University of Insubria, Italy; Gazi University, Turkey; Cliniques Universitaires Saint-Luc, Belgium; GHE-Hospices Civils de Lyon and Lyon 1 University, France; Odense University Hospital, Denmark; University of Milan, Italy; University of Duisburg-Essen, Germany; Interdisciplinary Centre for Graves' Orbitopathy, Switzerland; Johannes Gutenberg University Medical Center, Germany; Cardiff University School of Medicine, UK; University of Pisa, Italy; Royal Victoria Infirmary, UK; University Hospital of Wales, UK; Centre Hospitalier Lyon-Sud, France; Hospices Civils de Lyon, France; Academic Medical Center, Netherlands; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy; University of Belgrade, Serbia

DOI: 10.1136/bjophthalmol-2015-306733