Women are affected five times more than men and this has been linked to a higher incidence of Grave's disease in women. The median age is 43 years for all patients, with a range from 8 to 88 years old. Both men and women demonstrate a bimodal pattern of the age of diagnosis. TED has a higher prevalence in women than men. Patients treated with radioactive iodine may experience worsening of TED, especially if they are smokers. Stress is another environmental factor which may contribute to the worsening of TED. The greater the number of cigarettes smoked per day, the greater is the risk and giving up smoking has been linked with reduced risk. Among the environmental factors, smoking is the most consistently linked risk factor to the development or worsening of the disease. Include genetic, environmental, and immune factors. Thus, treatment of thyroid dysfunction does not necessarily affect course of Grave’s ophthalmopathy. While strict control of thyroid function is crucial in patients with TED, the course and severity of ocular manifestation does not always correlate with thyroid hormone levels. However about 10% of patients with TED have either a normal-functioning (Euthyroid) or under-functioning thyroid (Hypothyroidism e.g. TED is most frequently associated with Hyperthyroidism, consisting of approximately 90% of the cases. TED was previously known as thyroid-associated ophthalmopathy (TAO), Graves orbitopathy (GO) and other variations. TED is observed in ~ 50% of patients while Graves' dermopathy and acropachy are quite rare. Organs other than the thyroid can also be affected, leading to the extrathyroidal (outside the thyroid gland itself) manifestations of GD. Graves' disease (GD) is an autoimmune disorder involving the thyroid gland, typically characterized by the presence of circulating autoantibodies that bind to and stimulate the thyroid hormone receptor (TSHR), resulting in hyperthyroidism and goiter. The disorder characterized by enlargement of the extraocular muscles, fatty and connective tissue volume. TED is a rare disease, which had an incidence rate of approximately 19 in 100,000 people per year in one study. Thyroid eye disease (TED) is an autoimmune disease caused by the activation of orbital fibroblasts by autoantibodies directed against thyroid receptors.
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