THE TREATMENT OF GRAVES OPHTHALMOPATHY IN AN INCIDENCE COHORT

PURPOSE: To determine the frequencies of medical and surgical treatmen ts in an incidence cohort of 120 patients with Graves' ophthalmopathy. METHODS: We reviewed the community medical records and administered a follow-up questionnaire. RESULTS: Of the 120 patients, 89 (74.2%) req uired either no therapy or only supportive measures, Six patients (5.0 %) were treated with systemic corticosteroids, One patient had orbital radiotherapy, Twenty-four patients (20.0%) underwent one or more surg ical procedures. The cumulative probabilities of undergoing ophthalmic surgery of any type were 5.0% by one year after the diagnosis of opht halmopathy, 9.3% after two years, 15.9% after five years, and 21.8% af ter ten years, The need for surgery was significantly related to age ( P < .01; Cox proportional hazards model) but was not significantly dep endent on gender (P = .5) or the interaction of age and gender (P = .1 5), The overall risk of the need for surgery was 2.6 times greater in patients older than 50 years (95% confidence interval, 1.2 to 5.8) tha n in younger patients, There were no significant differences between t obacco smokers and nonsmokers in the cumulative probabilities of under going surgery. CONCLUSION: In 24 (20%) patients, one or more surgical procedures were used to treat Graves' ophthalmopathy, The probability of surgical intervention was significantly related to patient age (old er than 50 years), but it was not related to gender or smoking.