Risk Factors Associated with the Activity and Severity of Graves’ Ophthalmopathy among Patients at the University of the Philippines Manila-Philippine General Hospital

BACKGROUND: Asians with Graves’ ophthalmopathy (GO) may have earlier compressive features due to narrower orbital apex and increased orbital volume. OBJECTIVE: To determine the risk factors associated with activity and severity of GO among adults. METHODOLOGY: This was a cross-sectional analytical study of 163 adults with Graves’ disease (GD) from the outpatient clinics of the Philippine General Hospital. Demographics, clinical data, thyrotropin receptor antibody (TRAb) and urine iodine (UIE) levels were obtained. All participants were evaluated for activity and severity of GO by a single ophthalmologist. RESULTS: The population was predominantly composed of females (81%) and nonsmokers (69%), with a mean age of 35 + 11 years and median GD duration of 2 years. Median TRAb was 8.9 U/L while UIE was 171 mcg/L. Eight percent exhibited active GO, with 85% having mild disease. Multivariate analysis showed male sex to be associated with severe disease (OR 3.71, p=0.041), while elevated TRAb was associated with both active (OR 1.03, p=0.002) and severe GO (OR 1.02, p=0.007). CONCLUSION: Lower rates of active and severe GO were seen compared to previous reports. In this population of predominantly nonsmokers, elevated TRAb emerged as a risk factor for active and severe GO.