Ethnic variation in clinical and imaging features of thyroid eye disease.

Cohort studyOrbit (Amsterdam, Netherlands)· May 2026

Bryanna J Lee, Marissa K Shoji, Catherine Y Liu … Don O Kikkawa

Neuro-ophthalmologyCohort studyClinical practiceQ3IF 1.0

Asian and Hispanic patients develop thyroid eye disease over a decade earlier than White patients.

Bryanna J Lee … Don O Kikkawa

Orbit (Amsterdam, Netherlands) · May 2026 · Q3 in Ophthalmology

Purpose

To evaluate ethnic differences in thyroid eye disease (thyroid eye disease).

Methods

Were categorized as non-Hispanic White (W), Asian (A), Black (B), and Hispanic (H).

n = 354 patients

> 10 years

Results

> 10 years

Asian and Hispanic patients show first signs of eye disease years sooner

n = 354 patients

More results

Smoking was lowest in A ( p = .01).

Diplopia (46.4%, p = .001) and strabismus surgery (22.9%, p = .01) was most common in W.

B and H exhibited greater exophthalmos (B 22.8 ± 3.2 mm, H 22.1 ± 3.1 mm) than W and A (21.3 ± 3.6 mm, 21.0 ± 3.2 mm; p = .04).

More results

Medial and inferior recti were largest in B and smallest in A ( p = .002, p = .05), with reciprocal FMR (highest in A, lowest in W).

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Conclusion · 1 of 2

Across this large multiethnic cohort, thyroid eye disease manifestations varied by race/ethnicity, supporting distinct phenotypes.

Conclusion · 2 of 2

Integrating these patterns into evaluation can refine screening, counseling, and individualized surgical planning for diverse patient populations.