Pediatric Graves’ orbitopathy: a multicentre study

Ioana C. Ionescu, Paul A.S. van Trotsenburg, Dion Paridaens, Michael Tanck, Christiaan F. Mooij, Eliane Cagienard, Rachel Kalmann, Farzad Pakdel, Stijn van der Meeren, Peerooz Saeed*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Purpose: Graves’ orbitopathy (GO) is a rare condition in children often considered to be a less severe condition than at an older age. The aim of our study was to analyse if there are any factors that distinguish paediatric from adult GO in order to provide guidelines for assessing and managing paediatric GO. Methods: Study design is a multicentre retrospective observational case series; 115 paediatric patients diagnosed with GO who visited our university medical centres in the Netherlands and Iran between 2003 and 2019 were submitted for complete ophthalmological examinations, serological testing and/or orbital imaging. Main outcome measures focussed on the natural course and clinical picture as well as medical and surgical treatment in paediatric GO. Results: Clinical findings included proptosis (n = 97; 84.3%), eyelid retraction (n = 77; 67%) and diplopia (n = 13; 11.3%). Ninety-two patients (80%) presented with mild disease, 21 (18.3%) with moderate-severe disease and two (1.7%) with severe GO. Five patients (4.3%) underwent intravenous glucocorticoids and 25 patients underwent orbital decompression surgery. Strabismus surgery due to primary involvement of extraocular muscles was performed in two patients (1.7%). Overall, rehabilitative surgical treatment was planned in 31 patients (26.9%) with inactive disease. Two patients experienced reactivation of the disease. Conclusion: Despite the fact that paediatric and adult GO are considered two separate entities, they might be the same disease with two different clinical phenotypes. Paediatric GO population presents with a comparable clinical picture regarding both soft tissue involvement and proptosis, which may require surgical intervention. Proptosis was present in the majority of paediatric GO patients. Orbital decompression was performed in 21.7% of patients.

Original languageEnglish
Pages (from-to)e1340-e1348
JournalActa Ophthalmologica
Issue number6
Early online dateSept 2022
Publication statusPublished - Sept 2022


  • Graves’ disease
  • Graves’ orbitopathy
  • orbital decompression
  • paediatric
  • rehabilitative surgery
  • severity
  • thyroid eye disease


Dive into the research topics of 'Pediatric Graves’ orbitopathy: a multicentre study'. Together they form a unique fingerprint.

Cite this