Cited by 228Ophthalmology and Eye DisordersThyroid Disorders and TreatmentsMyasthenia Gravis and Thymoma

The DOI matches its Crossref record.

Smoking and endocrine ophthalmopathy: impact of smoking severity and current vs lifetime cigarette consumption

Pfeilschifter, Johannes, Ziegler, Reinhard·1996·Clinical Endocrinology

DOI 10.1046/j.1365-2265.1996.8220832.x

Open this paper in CoChat — free account

Abstract

OBJECTIVE Smoking has been associated with an increased incidence of endocrine ophthalmopathy (EO). In this study we examined the relation between smoking severity and the incidence of EO symptoms in patients with Graves’ hyperthyroidism. DESIGN Patients were prospectively followed for at least one year after the onset of hyperthyroidism. Smoking and EO status were evaluated at 3−6‐ months intervals. PATIENTS Two hundred and fifty‐three ambulatory patients with recent onset of Graves’ hyperthyroidism were studied. MEASUREMENTS The incidence of total EO symptoms, proptosis, and diplopia at any time point before and after the occurrence of Graves’ hyperthyroidism was assessed by interview and physical examination. RESULTS Smoking was associated with a 1.3‐fold increase in the overall incidence of symptomatic EO, and a 2.6 and 3.1‐fold increase in the incidence of proptosis and diplopia, respectively. The relative risk increased in parallel with the current number of cigarettes smoked per day. In contrast, lifetime tobacco use was not an independent risk factor for the development of EO symptoms. Former smokers had a significantly lower risk for the occurrence of proptosis and diplopia than active smokers with a comparable lifetime cigarette consumption. CONCLUSIONS Our data suggest that current, but not lifetime, tobacco consumption constitutes a risk for the incidence of proptosis and diplopia in patients with Graves’ hyperthyroidism, and that this risk increases with smoking severity.

Integrity signals

Registry

Crossref · 10.1046/j.1365-2265.1996.8220832.x

Cites

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Sorted by citations

2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis
Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938
“The risk is proportional to the number of cigarettes smoked per day, and former smokers have significantly lower risk than current smokers, even after adjusting for lifetime cigarette consumption (537).”
Background
Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists
Bahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., Rivkees, S. A., et al. (2011) · Endocrine Practice · doi:10.4158/ep.17.3.456 · Cited by 1,098
“The risk is proportional to the number of cigarettes smoked per day and former smokers have significantly lower risk than current smokers, even after adjusting for lifetime cigarette consumption (325).”
Background
The 2021 European Group on Graves’ orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves’ orbitopathy
Bartalena, L., Kahaly, G. J., Baldeschi, L., Dayan, C. M., Eckstein, A. K., Marcocci, C., Marinò, M., Vaidya, B., Wiersinga, W. M., _, _., et al. (2021) · European Journal of Endocrinology · doi:10.1530/eje-21-0479 · Cited by 1,166
“…have more severe GO (3); development or progression of GO after radioactive iodine (RAI) treatment is more frequent in smokers (47, 48); smokers have a delayed or worse outcome of immunosuppressive treatments (47, 49, 50); smoking cessation is possibly associated with a better outcome of GO (51).”
Effects of tobacco smoke on immunity, inflammation and autoimmunity
Arnson, Y., Shoenfeld, Y., & Amital, H. (2009) · Journal of Autoimmunity · doi:10.1016/j.jaut.2009.12.003 · Cited by 966
“In an observational study, smoking cessation in Graves' patients was associated with a decreased risk for developing exophthalmos and diplopia [79].”
Background
The 2016 European Thyroid Association/European Group on Graves’ Orbitopathy Guidelines for the Management of Graves’ Orbitopathy
Bartalena, L., Baldeschi, L., Boboridis, K., Eckstein, A., Kahaly, G. J., Marcocci, C., Perros, P., Salvi, M., & Wiersinga, W. M. (2016) · European Thyroid Journal · doi:10.1159/000443828 · Cited by 943
Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists
The American Thyroid Association and American Association of Clinical Endocrinologists Taskforce on Hyperthyroidism and Other Causes of Thyrotoxicosis, Bahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., et al. (2011) · Thyroid · doi:10.1089/thy.2010.0417 · Cited by 898
“The risk is proportional to the number of cigarettes smoked per day and former smokers have significantly lower risk than current smokers, even after adjusting for lifetime cigarette consumption (325).”
Background
Consensus statement of the European Group on Graves' orbitopathy (EUGOGO) on management of GO
Bartalena, L., Baldeschi, L., Dickinson, A. J., Eckstein, A. K., Kendall‐Taylor, P., Marcocci, C., Mourits, M. P., Perros, P., Boboridis, K. G., Boschi, A., et al. (2008) · European Journal of Endocrinology · doi:10.1530/eje-07-0666 · Cited by 805
Management of Graves' Ophthalmopathy: Reality and Perspectives
Bartalena, L., Pinchera, A., & Marcocci, C. (2000) · Endocrine Reviews · doi:10.1210/edrv.21.2.0393 · Cited by 679
“Recently, Pfeilschifter and Ziegler (256) prospectively followed 253 patients with a recent onset of Graves’ hyperthyroidism and found that cigarette smoking was associated with a 1.3-fold increased incidence of clinically relevant GO and with 2.6-fold and 3.1-fold increases in the incidence of proptosis and diplopia,…”
BackgroundInfluential
Current Perspective on the Pathogenesis of Graves’ Disease and Ophthalmopathy
Prabhakar, B. S., Bahn, R. S., & Smith, T. J. (2003) · Endocrine Reviews · doi:10.1210/er.2002-0020 · Cited by 493
“9 for current and ex-smokers, suggesting a direct and immediate effect of smoking (188, 189).”
Background
Epidemiology and Prevention of Graves' Ophthalmopathy
Wiersinga, W. M., & Bartalena, L. (2002) · Thyroid · doi:10.1089/105072502761016476 · Cited by 457
Consensus Statement of the European Group on Graves' Orbitopathy (EUGOGO) on Management of Graves' Orbitopathy
Bartalena, L., Baldeschi, L., Dickinson, A. J., Eckstein, A., Kendall-Taylor, P., Marcocci, C., Mourits, M. P., Perros, P., Boboridis, K., Boschi, A., et al. (2008) · Thyroid · doi:10.1089/thy.2007.0315 · Cited by 406
“A dose–response relationship between numbers of cigarettes smoked per day and probability of developing GO has been demonstrated (21).”
Smoking and thyroid
Wiersinga, W. M. (2013) · Clinical Endocrinology · doi:10.1111/cen.12222 · Cited by 389
Epidemiology, Natural History, Risk Factors, and Prevention of Graves’ Orbitopathy
Bartalena, L., Piantanida, E., Gallo, D., Lai, A., & Tanda, M. L. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.615993 · Cited by 386
The Association Between Cigarette Smoking and Ocular Diseases
Solberg, Y., Rosner, M., & Belkin, M. (1998) · Survey of Ophthalmology · doi:10.1016/s0039-6257(98)00002-2 · Cited by 366
Graves' Ophthalmopathy
Bartalena, L., & Tanda, M. L. (2009) · New England Journal of Medicine · doi:10.1056/nejmcp0806317 · Cited by 341
Prevalence and Natural History of Graves' Orbitopathy in a Large Series of Patients With Newly Diagnosed Graves' Hyperthyroidism Seen at a Single Center
Tanda, M. L., Piantanida, E., Liparulo, L., Veronesi, G., Lai, A., Sassi, L., Pariani, N., Gallo, D., Azzolini, C., Ferrario, M., et al. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-3873 · Cited by 328
“that refraining from smoking decreases the risk of exophthalmos and diplopia (35), and reinforces the concept that patients with Graves’ disease should be urged to quit”
Background
New insights into the pathogenesis and nonsurgical management of Graves orbitopathy
Taylor, P. N., Zhang, L., Lee, R., Muller, I., Ezra, D. G., Dayan, C. M., Kahaly, G. J., & Ludgate, M. (2019) · Nature Reviews Endocrinology · doi:10.1038/s41574-019-0305-4 · Cited by 331
Smoking and thyroid disorders--a meta-analysis
Vestergaard, P. (2002) · European Journal of Endocrinology · doi:10.1530/eje.0.1460153 · Cited by 308
“Two studies reported a dose ‐ response relationship between number of cigarettes smoked in current smokers and risk of hyperthyroidism ( 13 , 15).”
Background
The environment and autoimmune thyroid diseases
Prummel, M. F., Strieder, T. G. A., & Wiersinga, W. M. (2004) · European Journal of Endocrinology · doi:10.1530/eje.0.1500605 · Cited by 298
Extrathyroidal manifestations of Graves’ disease: a 2014 update
Bartalena, L., & Fatourechi, V. (2014) · Journal of Endocrinological Investigation · doi:10.1007/s40618-014-0097-2 · Cited by 281
“Accordingly, patients should be firmly encouraged to refrain from smoking, because quitting smoking has been associated with a decreased risk of developing exophthalmos and extraocular muscle dysfunction [25].”
Current Concepts in the Molecular Pathogenesis of Thyroid-Associated Ophthalmopathy
Wang, Y., & Smith, T. J. (2014) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.14-14002 · Cited by 238
“Risk for developing TAO relates more to the number of cigarettes smoked following development of GD than the life-cumulative smoking burden.(65) In a matched case-control twin study, Brix et al.”
Background
Cigarette smoking and autoimmune disease: what can we learn from epidemiology?
Costenbader, K. H., & Karlson, E. W. (2006) · Lupus · doi:10.1177/0961203306069344 · Cited by 248
Cigarette smoking and thyroid eye disease: a systematic review
Thornton, J., Kelly, S. P., Harrison, R. A., & Edwards, R. (2006) · Eye · doi:10.1038/sj.eye.6702603 · Cited by 228
Current Insights into the Pathogenesis of Graves’ Ophthalmopathy
Bahn, R. S. (2015) · Hormone and Metabolic Research · doi:10.1055/s-0035-1555762 · Cited by 222
Impact of smoking on the response to treatment of thyroid associated ophthalmopathy
Eckstein, A. K. (2003) · British Journal of Ophthalmology · doi:10.1136/bjo.87.6.773 · Cited by 212
“8 The fact that no such correlation was observed 12 months after the beginnung of treatment indicates that the response to treatment is only delayed in smokers.”
Background
Pretibial Myxedema
Fatourechi, V. (2005) · American Journal of Clinical Dermatology · doi:10.2165/00128071-200506050-00003 · Cited by 207
Smoking and Thyroid-Associated Ophthalmopathy: A Novel Explanation of the Biological Link
Cawood, T., Moriarty, P., O’Farrelly, C., et al. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-1824 · Cited by 200
Current concepts regarding Graves’ orbitopathy
Bartalena, L., & Tanda, M. L. (2022) · Journal of Internal Medicine · doi:10.1111/joim.13524 · Cited by 215
Evaluating Graves’ Orbitopathy
Dolman, P. J. (2012) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2011.11.007 · Cited by 185
Smoking as a Risk Factor for Graves' Disease, Toxic Nodular Goiter, and Autoimmune Hypothyroidism
Vestergaard, P., Rejnmark, L., Weeke, J., Hoeck, H. C., NIELSEN, H. K., Rungby, J., Laurberg, P., & Mosekilde, L. (2002) · Thyroid · doi:10.1089/105072502753451995 · Cited by 128
Prevalence and natural history of Graves' orbitopathy in the XXI century.
Piantanida, E., Tanda, M. L., Lai, A., Sassi, L., & Bartalena, L. (2013) · PubMed · doi:10.3275/8937 · Cited by 120
Risk Factors for Graves' Orbitopathy; the Australian Thyroid-Associated Orbitopathy Research (ATOR) Study
Khong, J. J., Finch, S. J., Silva, C. D., Rylander, S., Craig, J. E., Selva, D. N., & Ebeling, P. R. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-4294 · Cited by 120
“Current number of cigarettes smoked a day dictate the incidence risk of GO, but not lifetime cigarette consumption (24).”
Background
Thyroid Acropachy: Report of 40 Patients Treated at a Single Institution in a 26-Year Period
Fatourechi, V., Ahmed, D. D. F., & Schwartz, K. M. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-020746 · Cited by 116
“Orbital decompression 21 (53) Transfrontal 2 (5) Transantral 19 (48) Some type of eye operation 22 (55) Systemic corticosteroids 20 (50) Corticosteroids or eye operation 25 (63) Orbital radiotherapy 2 (5) Eye muscle or eyelid operation 19 (48) TABLE 2.”
Background
Grading Severity and Activity in Thyroid Eye Disease
Dolman, P. J. (2018) · Ophthalmic Plastic and Reconstructive Surgery · doi:10.1097/iop.0000000000001150 · Cited by 117
“Cigarette smoking is strongly correlated with both the development of TED and with its severity.(15,16) Recurrence of TED occurs in less than 10% of cases.”
Background
Prevalence, Risk Factors, and Clinical Features of Thyroid-Associated Ophthalmopathy in Multiethnic Malaysian Patients with Graves' Disease
Lim, S. L., Lim, A. K. E., Mumtaz, M., Hussein, E., Bebakar, W. M. W., & Khir, A. S. M. (2008) · Thyroid · doi:10.1089/thy.2008.0044 · Cited by 110
Relationship between cigarette smoking and Graves’ ophthalmopathy
Hegedűs, L. D., Brix, T. H., & Vestergaard, P. (2004) · Journal of Endocrinological Investigation · doi:10.1007/bf03345276 · Cited by 109
Environmental tobacco smoke exposure and eye disease
Lois, N., Abdelkader, E., Reglitz, K., Garden, C., & Ayres, J. G. (2008) · British Journal of Ophthalmology · doi:10.1136/bjo.2008.141168 · Cited by 110
Prevention of Graves’ ophthalmopathy
Bartalena, L. (2012) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2011.09.004 · Cited by 98
Thyroid eye disease (Graves' orbitopathy): clinical presentation, epidemiology, pathogenesis, and management
Wiersinga, W. M., Eckstein, A. K., & Žarković, M. (2025) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(25)00066-x · Cited by 132
Management of Graves' ophthalmopathy
Wiersinga, W. M. (2007) · Nature Clinical Practice Endocrinology & Metabolism · doi:10.1038/ncpendmet0497 · Cited by 93
“7) among ex-smokers who formerly smoked more than 20 cigarettes daily (reviewed by Pfeilschifter and Ziegle”
Background
Long-term results of irradiation for patients with progressive GRAVES’ ophthalmopathy
Marquez, S. D., Lum, B. L., McDougall, I. R., Katkuri, S., Levin, P. S., MacManus, M. P., & Donaldson, S. S. (2001) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/s0360-3016(01)01699-6 · Cited by 93
The Evaluation and Treatment of Graves Ophthalmopathy
Stan, M. N., Garrity, J. A., & Bahn, R. S. (2012) · Medical Clinics of North America · doi:10.1016/j.mcna.2012.01.014 · Cited by 92
Smoking and autoimmune thyroid disease: the plot thickens
Krassas, G. E., & Wiersinga, W. M. (2006) · European Journal of Endocrinology · doi:10.1530/eje.1.02157 · Cited by 83
“The best evidence for primary prevention of GO by quitting smoking comes from a study by Pfeilschifter and Ziegler ( 15 ).”
Background
Unlocking the immunological mechanisms of orbital inflammation in thyroid eye disease
Ludgate, M. E., & Baker, G. (2002) · Clinical & Experimental Immunology · doi:10.1046/j.1365-2249.2002.01792.x · Cited by 83
Graves' ophthalmopathy: a preventable disease?
Bartalena, L., Marcocci, C., & Pinchera, A. (2002) · European Journal of Endocrinology · doi:10.1530/eje.0.1460457 · Cited by 84
“In a recent prospective study of 253 patients with Graves’ disease, cigarette smoking was associated with a 1.3-fold increase in the risk of developing clinical ophthalmopathy, and with 2.6-fold and 3.1-fold increases in risk of developing proptosis and diplopia respectively ( 13 ).”
BackgroundInfluential
Effects of smoking on ocular health
Galor, A., & Lee, D. J. (2011) · Current Opinion in Ophthalmology · doi:10.1097/icu.0b013e32834bbe7a · Cited by 80
Current and Emerging Treatment Strategies for Graves’ Orbitopathy
Genere, N., & Stan, M. N. (2019) · Drugs · doi:10.1007/s40265-018-1045-9 · Cited by 78
Graves’ ophthalmopathy: a rational approach to treatment
Wiersinga, W. M., & Prummel, M. F. (2002) · Trends in Endocrinology and Metabolism · doi:10.1016/s1043-2760(02)00622-7 · Cited by 72
Graves' Orbitopathy: Imperfect Treatments for a Rare Disease
Bartalena, L. (2013) · European Thyroid Journal · doi:10.1159/000356042 · Cited by 70
Steroid-Resistant Graves’ Orbitopathy Treated with Tocilizumab in Real-World Clinical Practice: A 9-Year Single-Center Experience
Pérez-Moreiras, J. V., Varela-Agra, M., Prada-Sánchez, M. C., & Prada-Ramallal, G. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10040706 · Cited by 75
“Smoking increases the risk of developing GO [37], adversely affects prognosis [38,39], and alters the response to treatment [40,41].”
Background
Thyroid Eye Disease: Epidemiology, Natural History, and Risk Factors
Bartalena, L., Gallo, D., Tanda, M. L., & Kahaly, G. J. (2023) · Ophthalmic Plastic and Reconstructive Surgery · doi:10.1097/iop.0000000000002467 · Cited by 73
Update on thyroid eye disease and management
Harrison, A. R., Bothun, E. D., Scheuer, R. A., & Lee (2009) · Clinical ophthalmology · doi:10.2147/opth.s5228 · Cited by 63
Smoking under hypoxic conditions: a potent environmental risk factor for inflammatory and autoimmune diseases
Hussain, M. S., & Tripathi, V. (2018) · Military Medical Research · doi:10.1186/s40779-018-0158-5 · Cited by 62
Optimal management of Graves orbitopathy: a multidisciplinary approach.
Soeters, M. R., van Zeijl, C. J. J., Boelen, A., Kloos, R., Saeed, P., Vriesendorp, T. M., & Mourits, M. P. (2011) · PubMed · Cited by 51
Health effects of cigarette smoking
Skurnik, Y. D. (1998) · Clinics in Dermatology · doi:10.1016/s0738-081x(98)00037-6 · Cited by 49
Risk Factors of Thyroid Eye Disease
Lee, M. H., Chin, Y. H., Ng, C. H., Nistala, K. R. Y., Ow, Z. G. W., Sundar, G., Yang, S. P., & Khoo, C. M. (2020) · Endocrine Practice · doi:10.1016/j.eprac.2020.11.011 · Cited by 49
Risk Factors Associated with the Severity of Thyroid-Associated Orbitopathy in Korean Patients
Lee, J. H., Lee, S. Y., & Yoon, J. S. (2010) · Korean Journal of Ophthalmology · doi:10.3341/kjo.2010.24.5.267 · Cited by 47
“We have confirmed that smoking is the strongest risk factor for development of a severe course of TAO and optic neuropathy in Korean patients, as observed in previous studies [6,15-19].”
BackgroundResult
Thyroid Eye Disease: Towards an Evidence Base for Treatment in the 21st Century
Gillespie, E. F., Smith, T. J., & Douglas, R. S. (2012) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-012-0256-9 · Cited by 46
An update on medical management of Graves’ ophthalmopathy
Bartalena, L., Marcocci, C., Tanda, M. L., Piantanida, E., Lai, A., Marinò, M., & Pinchera, A. (2005) · Journal of Endocrinological Investigation · doi:10.1007/bf03347230 · Cited by 44
Cigarette Smoke Extract‐Induced Oxidative Stress and Fibrosis‐Related Genes Expression in Orbital Fibroblasts from Patients with Graves’ Ophthalmopathy
Kau, H., Wu, S., Tsai, C., et al. (2016) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2016/4676289 · Cited by 42
Current and Future Treatments for Graves’ Disease and Graves’ Ophthalmopathy
Kotwal, A., & Stan, M. N. (2018) · Hormone and Metabolic Research · doi:10.1055/a-0739-8134 · Cited by 41
“Smoking also curtails the effectiveness of immunosuppressive treatment for GO [81], and smoking cessation has been associated with lower risk of adverse outcomes from GO including diplopia and exophthalmos [82].”
Background
Update on thyroid eye disease: Regional variations in prevalence, diagnosis, and management
Yu, C., Ford, R. L., Wester, S. T., & Shriver, E. M. (2022) · Indian Journal of Ophthalmology · doi:10.4103/ijo.ijo_3217_21 · Cited by 40
“[53‐55] Fortunately, smoking cessation has been shown to be effective at reversing these changes as ex‐smokers displayed no increased risk of developing orbitopathy, diplopia, or proptosis compared to never smokers in one cohort study.[56] Smoking prevalence has been shown to vary based on geographic region, with the…”
Background
Lack of Association between Selenium Status and Disease Severity and Activity in Patients with Graves' Ophthalmopathy
Dehina, N., Hofmann, P. J., Behrends, T., Eckstein, A. K., & Schomburg, L. (2016) · European Thyroid Journal · doi:10.1159/000442440 · Cited by 37
Endocrine and metabolic effects of smoking cessation
Berlin, I. (2009) · Current Medical Research and Opinion · doi:10.1185/03007990802707626 · Cited by 36
Retro-orbital autoimmunity
Heufelder, A. E. (1997) · Baillière s Clinical Endocrinology and Metabolism · doi:10.1016/s0950-351x(97)80723-9 · Cited by 35
Thyroid Orbitopathy
Wang, Y., Tooley, A. A., Mehta, V. J., Garrity, J. A., Harrison, A. R., & Mettu, P. (2018) · International Ophthalmology Clinics · doi:10.1097/iio.0000000000000219 · Cited by 33
Long‐term outcomes in corticosteroid‐refractory Graves' orbitopathy treated with tocilizumab
Moi, L., Hamedani, M., & Ribi, C. (2021) · Clinical Endocrinology · doi:10.1111/cen.14655 · Cited by 33
“For mild forms, supplementation in selenium, smoking cessation, and stabilization of thyroid function can result effective.(12,13) Nonetheless, about 2% of GO require immunosuppressive therapy.”
Background
Teprotumumab and the Evolving Therapeutic Landscape in Thyroid Eye Disease
Kossler, A. L., Douglas, R. S., & Dosiou, C. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac168 · Cited by 32
“Risk factors include smoking, female sex, age, radioactive iodine treatment, thyroid dysfunction, elevated levels of thyrotropin receptor antibodies, vitamin D deficiency, and potentially hypercholesterolemia (6-9).”
Background
Volume Changes in Intra- and Extraorbital Compartments in Patients with Graves' Ophthalmopathy: Effect of Smoking
Szucs‐Farkas, Z., Tóth, J., Kollár, J., et al. (2005) · Thyroid · doi:10.1089/thy.2005.15.146 · Cited by 32
Graves Orbitopathy: Update on Diagnosis and Therapy
Melcescu, E., Horton, W. B., Kim, D., Vijayakumar, V., Corbett, J. J., Crowder, K. W., Pitman, K. T., Uwaifo, G. I., & Koch, C. A. (2014) · Southern Medical Journal · doi:10.1097/smj.0000000000000038 · Cited by 32
“Current smokers seem to have a higher risk for GO than former smokers.(21) The treatment of GO with orbital radiotherapy and high-dose steroids appears to be negatively influenced by cigarette smoking.”
Background
Thyroid Eye Disease
Cockerham, K. P., & Chan, S. S. (2010) · Neurologic Clinics · doi:10.1016/j.ncl.2010.03.010 · Cited by 32
Anti-oxidative and anti-adipogenic effects of caffeine in an in vitro model of Graves’ orbitopathy
Ko, J., Kim, J.-Y., Kim, J. W., et al. (2020) · Endocrine Journal · doi:10.1507/endocrj.ej19-0521 · Cited by 30
“Based on clinical reports, ciga‐ rette smoking—likely the most important environmental factor associated with GO occurrence and progression— may act, among other mechanisms, by stimulating the generation of ROS and reducing antioxidant production [3, 20, 21].”
Background
Reversal of Pathological Features of Graves' Orbitopathy by Activation of Forkhead Transcription Factors, FOXOs
Zhang, L., Ji, Q. H., Ruge, F., Lane, C., Morris, D., Tee, A. R., Dayan, C. M., & Ludgate, M. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-2932 · Cited by 30
Management of thyroid eye disease
Bartalena, L., Marcocci, C., Tanda, M. L., et al. (2002) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-002-0813-6 · Cited by 29
“Ex-smokers have a lower risk for TED than current smokers [ 57 ].”
Background
Influence of cigarette smoking on thyroid function, goiter formation and autoimmune thyroid disorders
Pontikides, N., & Krassas, G. (2002) · HORMONES · doi:10.14310/horm.2002.1156 · Cited by 29
General Management Plan
Boboridis, K. G., & Perros, P. (2007) · KARGER eBooks · doi:10.1159/000107451 · Cited by 29
Effect of smoking on retrobulbar blood flow in thyroid eye disease
Sadeghi-Tari, A., Jamshidian-Tehrani, M., Nabavi, A., et al. (2016) · Eye · doi:10.1038/eye.2016.184 · Cited by 28
Neutrophil-to-Lymphocyte, Monocyte-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Relation to Clinical Parameters and Smoking Status in Patients with Graves’ Orbitopathy—Novel Insight into Old Tests
Szydełko, J., Litwińczuk, M., Szydełko, M., et al. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9103111 · Cited by 26
Macrophage-Orbital Fibroblast Interaction and Hypoxia Promote Inflammation and Adipogenesis in Graves’ Orbitopathy
Görtz, G.-E., Philipp, S., Bruderek, K., Jesenek, C., Horstmann, M., Henning, Y., Oeverhaus, M., Daser, A., Bechrakis, N. E., Eckstein, A. K., et al. (2022) · Endocrinology · doi:10.1210/endocr/bqac203 · Cited by 28
Thyroid Eye Disease and its Vision-Threatening Manifestations in the Academy IRIS Registry: 2014-2018
Ramesh, S., Zhang, Q., Sharpe, J. E., et al. (2023) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2023.04.013 · Cited by 25
Thyroid associated ophthalmopathy - a review.
Mallika, P., Tan, A. S. A., Aziz, S., et al. (2009) · PubMed · Cited by 24
Smoking and systemic disease
Mallampalli, A., & Guntupalli, K. K. (2004) · Medical Clinics of North America · doi:10.1016/j.mcna.2004.07.001 · Cited by 35
“Pfeilschifter and Ziegler [34] showed an increased risk of symptomatic ophthalmopathy in smokers with Graves’ disease.”
Background
Sight-Threatening Thyroid Eye Disease: Role of Diabetes Mellitus and Interaction with Other Risk Factors
Rath, S., Pattnaik, M., Tripathy, D., Mohapatra, S., Panigrahy, B., & Ali, M. H. (2020) · Ophthalmic Plastic and Reconstructive Surgery · doi:10.1097/iop.0000000000001871 · Cited by 25
“This is also apparently related to the severity of smoking.(23) The biological mechanism by which smoking causes TED is unknown.”
Background
Are Ethnicity, Social Grade, and Social Deprivation Associated With Severity of Thyroid-Associated Ophthalmopathy?
Edmunds, M. R., Huntbach, J., & Durrani, O. M. (2014) · Ophthalmic Plastic and Reconstructive Surgery · doi:10.1097/iop.0000000000000077 · Cited by 23
“However, smoking is the risk factor that has been most consistently associated with the development and severity of TAO, with those who stop smoking for at least a year having a risk equivalent to never smokers.(14,21) In other studies, more than 40% of smokers either developed or had worsening of TAO, almost double t…”
BackgroundResult
Smoking and systemic disease.
Mallampalli, A., & Guntupalli, K. K. (2006) · PubMed · doi:10.1016/j.coem.2005.10.002 · Cited by 22
Establishment of a tear protein biomarker panel differentiating between Graves’ disease with or without orbitopathy
Aass, C., Norheim, I., Eriksen, E. F., Børnick, E. C., Thorsby, P. M., & Pepaj, M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0175274 · Cited by 21
“3), showing that about 40% of the GO patients smoke, which has also been suggested in previous studies [14].”
Result
(131)I and thyroid-associated ophthalmopathy
ÅK, R., Nygaard, B., & Feldt‐Rasmussen, U. (2000) · European Journal of Endocrinology · doi:10.1530/eje.0.1430155 · Cited by 21
Associations of CTLA4 Gene Polymorphisms with Graves’ Ophthalmopathy: A Meta-Analysis
Du, P., Ma, X., & Wang, C. (2014) · International Journal of Genomics · doi:10.1155/2014/537969 · Cited by 20
“As was reported, the odds ratio for both current smokers and exsmokers was high and the GO was more severe in smokers than in nonsmokers [35–37].”
Background
Smoking Is Associated With a Higher Risk of Surgical Intervention for Thyroid Eye Disease in the IRIS Registry
Oke, I., Reshef, E. R., Elze, T., Miller, J. W., Lorch, A., Hunter, D. G., & Freitag, S. K. (2023) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2023.01.020 · Cited by 23
New Onset or Deterioration of Thyroid Eye Disease After mRNA SARS-CoV-2 Vaccines: Report of 2 Cases and Literature Review
Mohamed, A., Tzoulis, P., Kossler, A. L., & Dosiou, C. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac606 · Cited by 19
Recent advances in graves ophthalmopathy medical therapy: a comprehensive literature review
Li, X., Li, S., Fan, W., Rokohl, A. C., Ju, S., Ju, X., Guo, Y., & Heindl, L. M. (2022) · International Ophthalmology · doi:10.1007/s10792-022-02537-6 · Cited by 26
Suck and spit, don’t blow
Katz, S. E., Lubow, M., & JACOBY, J. J. (1999) · Ophthalmology · doi:10.1016/s0161-6420(99)00713-7 · Cited by 19
Tear film break-up patterns in thyroid eye disease
Takahashi, Y., Lee, P. A. L., Vaidya, A., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-84661-4 · Cited by 19
Graves orbitopathy: a perspective
Perros, P., & Krassas, G. E. (2009) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.61 · Cited by 16
Thyroid eye disease- an update
Draman, M. S., & Ludgate, M. E. (2016) · Expert Review of Ophthalmology · doi:10.1080/17469899.2016.1202113 · Cited by 18
Endokrine Orbitopathie
Eckstein, A. K., & Esser, J. (2003) · Der Ophthalmologe · doi:10.1007/s00347-003-0873-4 · Cited by 16
Preoperative clinical features of reactivated of Graves’ orbitopathy after orbital decompression
Do, Y. W., Kim, J. W., & Yoon, J. S. (2017) · Eye · doi:10.1038/eye.2016.304 · Cited by 16
Compressive Optic Neuropathy in Thyroid Eye Disease
Thyparampil, P. J., & Yen, M. T. (2015) · International Ophthalmology Clinics · doi:10.1097/iio.0000000000000096 · Cited by 17
“Cessation of smoking has been found to reduce risk to that similar to nonsmokers.(3) The most common examination finding in TED is eyelid retraction (90%), followed by exophthalmos (60%), and restrictive extraocular motility (40%).”
Background
Novel Approaches to the Management of Graves` Ophthalmopathy
Bartalena, L., Tanda, M. L., Medea, A., Marcocci, C., & Pinchera, A. (2002) · HORMONES · doi:10.14310/horm.2002.1155 · Cited by 17
Orbital inflammation
Cockerham, K. P., Hong, S. H., & Browne, E. E. (2003) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-003-0023-z · Cited by 17

Authors: Pfeilschifter, J., & Ziegler, R.
Affiliations: Heidelberg University (DE)
Corresponding author: Pfeilschifter, Johannes
Venue: Clinical Endocrinology
Publisher: Wiley
Published: 1996-10
Volume: 45
Issue: 4
Pages: 477-481
ISSN: 0300-0664 (ISSN-L)
1365-2265
DOI: 10.1046/j.1365-2265.1996.8220832.x
OpenAlex: W1986559988
Cited by: 227
References: 0
Citations by year: 2026: 5 · 2025: 11 · 2024: 9 · 2023: 11 · 2022: 9 · 2021: 9 · 2020: 12 · 2019: 9 · 2018: 7 · 2017: 4 · 2016: 15 · 2015: 7 · 2014: 17 · 2013: 7 · 2012: 6
FWCI: 1.94
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 2584 d)
Locations: Clinical Endocrinology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Ophthalmology › Ophthalmology and Eye Disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Clinical Neurology › Myasthenia Gravis and Thymoma
Keywords: smoking, endocrine ophthalmopathy, Graves' hyperthyroidism, proptosis, diplopia, former smokers, risk factors
MeSH terms: Adult, Diplopia, Exophthalmos, Female, Graves Disease, Humans, Male, Middle Aged, Prospective Studies, Risk, Smoking, Incidence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Smoking and endocrine ophthalmopathy: impact of smoking severity and current vs lifetime cigarette consumption

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cited by

Related

Metadata

Record

About these checks