Abstract
BACKGROUND: Endocrine orbitopathy (EO) encompasses functional and cosmetic limitations. The aim of this study was to assess the health services situation of patients with EO treated at a multidisciplinary specialized center. METHODS: The medical records pertaining to the clinical spectrum, access route, and medical specialty of the referring physician of patients who were treated within a period of 5 years at a tertiary referral orbit center were systematically assessed. RESULTS: A total of 431 subjects with EO (female n =354, 82%; median age 40 years, range 5-79 years) were included in the study. Of the patients 148 (35%) and 123 (29%) were referred by family physicians and ophthalmologists, respectively. A sight-threatening optic nerve neuropathy was present in 11 (14.3%) men and 21 (5.9%) women (p =0.011). At least 2 other autoimmune diseases were found in 8 (10.4%) men and in 15 (4.3%) women (p =0.079). Psychotherapeutic support was utilized by 2 (2.6%) men and 92 (26%) women (p <0.001). An access route of 50 km or more was accepted by 14 (28%) men and 83 (43%) women (p =0.054). There was also an association between an access route ≥100 km and a prior medical treatment (odds ratio 3.78, 95% confidence interval 1.18-12.05, p =0.025). CONCLUSION: Men were more severely affected by EO than women and often had complex autoimmune diseases; however, male patients were less frequently willing to accept long access routes and barely used psychosocial support. Especially patients with further autoimmune diseases travelled long distances to be treated at a specialized center.