Age and gender influence on clinical manifestations of thyroid-associated ophthalmopathy: a case series of 2479 Chinese patients.

Background: Significant individual differences exist in the clinical manifestations of thyroid-associated ophthalmopathy (TAO). Age and gender have an impact on the presentation and severity of TAO.

Objective: To evaluate the clinical characteristics of TAO patients, with particular consideration of their age and gender.

Methods: Demographic and clinical data of 2479 TAO patients were collected. Patients were divided into 7 groups based on age: Group 1: ≤18 years old; Group 2: 19-29 years old; Group 3: 30-39 years old; Group 4: 40-49 years old; Group 5: 50-59 years old; Group 6: 60-69 years old; Group 7: ≥70 years old. Compared clinical manifestations among different groups and between males and females.

Result: In age group 1, the ratio of female to male TAO patients was 3.79, and in age group 7, it was 0.86. As age increased, there was a decline in the percentage of females (γ=-0.168, <0.001). During the aging process, the proportion of TAO patients with unilateral involvement also gradually decreased (γ=-0.23, <0.001). In addition, the proportion of TAO patients with upper eyelid retraction ≥2mm and exophthalmometry ≥17mm also decreased (γ=-0.158, <0.001, γ=-0.23, <0.001). In comparison to males, females with TAO showed a higher proportion of unilateral eye involvement and upper eyelid retraction ≥2mm (=0.038, <0.001). However, males had a higher proportion of exophthalmometry ≥17mm (<0.001). The proportions of patients with eye movement disorder (γ=0.535, <0.001), diplopia (γ=0.446, <0.001), intraocular pressure (IOP) ≥30mmHg (γ=0.149, <0.001), sight-threatening TAO (γ=0.479, <0.001), and active TAO (γ=0.469, <0.001) were positively correlated with age in TAO patients. Additionally, the proportion of male patients is higher than that of female patients.

Conclusion: TAO Patients exhibit different clinical features depending on age and gender. In elderly and male patients, TAO tends to be more severe, with a higher prevalence of eye muscle involvement, IOP ≥30mmHg, active phases, and a lower proportion of patients with upper eyelid retraction ≥2mm. Elderly female patients also have a lower proportion of exophthalmometry ≥17mm.