Unique clinical patterns emerge in pediatric thyroid eye disease cases

Pediatric thyroid eye disease (TED) exhibits distinct clinical features compared to adult TED, according to a poster presented at AAO 2023, that found that lower eyelid retraction is much more common in pediatric TED cases.

The study also highlights the significant correlation between thyroid receptor antibody (TRAB) positivity and the presence of lower eyelid retraction and acquired epiblepharon in pediatric TED patients.

The study identified a total of 35 cases of pediatric TED, with an average age of 12.7 years. Among the patients, 86% presented with hyperthyroidism, and 77% were found to be positive for TRAB.

Eyelid retraction was the most prevalent symptom, observed in 94% of the cases, with scleral show (lower > upper) and acquired epiblepharon present in 69% of patients. Additionally, conjunctival injection was noted in 54% of cases, while proptosis was seen in 26%.

Principal component analysis revealed a significant correlation between TRAB-positivity and the presence of lower eyelid retraction and acquired epiblepharon. This finding underscores the importance of TRAB in understanding and diagnosing pediatric TED.

Reference

Boniao EL, et al. Beyond Upper Lid Retraction: The Importance of Lower Eyelid Retraction and Acquired Epiblepharon in Pediatric TED. Presented at: AAO 2023.