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Table 1 Selection criteria

From: Prevalence of hyperthyroidism, hypothyroidism, and euthyroidism in thyroid eye disease: a systematic review of the literature

Author

Study design

Endocrinological diagnosis of thyroid status

Ophthalmological diagnosis of TED

Exclusion of secondary to thyroid disease treatment thyroid hormone status at TED onset

Observations

Ackuaku-Dogbe et al. [24]

Cross-sectional

Thyroid function tests and physical examination

By ophthalmologist

Authors measured the thyroid status at the time the first treatment of the disease was established

NA

Expósito et al. [25]

Cross-sectional

Thyroid function tests

According to information register in clinical records

Information of basal hormonal status was extracted from the data of the cause of the disease (GD or Hashimoto thyroiditis)

This study only includes glucocorticoid-treated patients for an active moderate-severe TED status and does not explain through which criteria the patients were diagnosed with TED

Bartley et al. [14]

Cross-sectional

Thyroid function tests

By ophthalmologist and imaging tests

Authors measured the thyroid status diagnosis index registered on the medical records

The patients classified as primary hypothyroidism and Hashimoto thyroiditis (all patients were in hypothyroid status) were merged into the hypothyroid group to calculate the prevalence

Eckstein et al. [15]

Cohort study

Thyroid function tests

According to information register in clinical records

Investigators measured the thyroid status before or within 6 months after the onset of TED

NA

Jang et al. [26]

Case-Control

Thyroid function tests

By ophthalmologist and CT scans

The diagnosis of euthyroidism was based on normal serum hormone levels and no clinical history of hyperthyroidism. Hyperthyroidism was established using hormonal criteria and if the patient had a history of antithyroid therapy, in this last group only patients that remained hyperthyroid were included.

Hypothyroid patients were not included in the study

Kashkouli et al. [23]

Cross-sectional

Thyroid function tests, thyroid gland-scan, and sonography

By a specialized ophthalmological clinic

The classification of thyroid hormone status was made according to the primary thyroid diagnosis register on the clinical records

A limitation of this study is the underestimation of euthyroid patients. This study included patients from the thyroid disorder and not from the ophthalmological diagnosis, euthyroid patients were excluded from the beginning and therefore were not evaluated by ophthalmology

Khoo et al. [27]

Cohort study

Thyroid function tests

By experienced endocrinologists and for equivocal cases further evaluations were carried out by ophthalmology colleagues

The study did not mention possible causes of secondary hormonal status on the patients (following thyroid disease treatment)

The total number of patients with TED identified at the Thyroid Clinic was calculated according to the patients that were initially included in the study (1020). 1001 were excluded because they had previous history of thyrotoxicosis or hyperthyroidism (we included these patients into the hyperthyroid group), 10 had subclinical thyrotoxicosis (these patients were added to the hyperthyroid group), and the other 9 patients were in hypothyroid or euthyroid status

McKeag et al. [28]

Cross-sectional

Thyroid function tests

By ophthalmologist and imaging tests

The criteria of the study included only patients with Graves’ thyrotoxicosis before or at the time of diagnosis of TED and only patients with primary hypothyroidism are named in the study.

 

Medghalchi et al. [29]

Cross-sectional

Thyroid function tests

By ophthalmologist, imaging tests and visual field analysis

The study did not mention possible causes of secondary hormonal status on the patients (following thyroid disease treatment)

 

Mukasa et al. [30]

Cross-sectional

Thyroid function tests

By a specialized ophthalmological clinic

All the patients included were untreated and were assessed for GO within 3 months of their initial visit to the hospital

It is not clear if the prevalence of hypothyroidism was cero in this group or if at the beginning of the study these patients were excluded

Ponto et al. [31]

Cross-sectional

By a specialized autoimmune (endocrine) clinic

By independent ophthalmologist or a specialized thyroid–eye clinic

The primary hormone levels were measured according to the autoimmune-associated thyroid disease

A limitation of this study is the underestimation of euthyroid patients. This study initially included patients with autoimmune thyroid disease (GD and Hashimoto’s thyroiditis), euthyroid patients were not included in the initial selection criteria and were gathered with hypothyroid patients

Ponto et al. [32]

Cross-sectional

Thyroid function tests

By an ophthalmologist

The primary thyroid status was measured 6 months before or after TED diagnosis

NA

Cozma et al. [33]

Cross-sectional

By a specialized thyroid–eye clinic, thyroid function tests

By a specialized thyroid-eye clinic

Patients with normal thyroid function tests, no history of disease or treatment, no clinical signs or symptoms of thyroid disease were included

NA