{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T20:02:28Z","timestamp":1784836948306,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010321","name":"Oogfonds","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010321","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002908","name":"Stichting Combined Ophthalmic Research Rotterdam","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002908","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010378","name":"Stichting Wetenschappelijk Onderzoek Oogziekenhuis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010378","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010372","name":"Rotterdamse Stichting Blindenbelangen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010372","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010331","name":"Stichting voor Ooglijders","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010331","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Quality of life (QoL) is a key outcome in Graves' orbitopathy (GO), but prior studies have reported overall QoL changes without evaluating whether improvements occur specifically in patients who achieve objective clinical response. Thus, it remains unclear to what extent clinical response translates into improved QoL, or whether treatment failure adversely affects well\u2010being.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this prospective study, 40 patients with moderate\u2010to\u2010severe active GO were assessed at baseline and 12 and 24\u2009weeks after initiation of intravenous methylprednisolone (IVMP). Clinical response was assessed based on clinical activity score (CAS) improvement. QoL was evaluated using GO\u2010QOL (function and appearance) and TED\u2010QOL (overall, function and appearance) questionnaires.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n At 24\u2009weeks, GO\u2010QOL function declined in non\u2010responders but not in responders. However, this difference was no longer significant after adjustment for confounders. For TED\u2010QOL overall and function domains, treatment response at 12\u2009weeks remained an independent predictor of QoL improvement after adjustment. Additionally, responders demonstrated a more favourable QoL trajectory during the first 12\u2009weeks. Clinically meaningful improvement in all TED\u2010QOL domains was more frequent in responders at 12\u2009weeks, whereas deterioration in TED\u2010QOL overall and function domains was more common in non\u2010responders. No such pattern was observed for GO\u2010QOL. TED\u2010QOL, but not GO\u2010QOL, demonstrated fair to moderate agreement between clinical response and clinically meaningful improvement at 12\u2009weeks.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Clinical response to IVMP is associated with substantial short\u2010term gains in TED\u2010QOL, whereas non\u2010responders face a higher risk of QoL decline. In contrast, GO\u2010QOL does not reflect clinical response.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aos.70199","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T19:09:41Z","timestamp":1784833781000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The relation between clinical response and quality of life improvement after treatment with intravenous methylprednisolone in Graves' orbitopathy"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3916-0012","authenticated-orcid":false,"given":"Gijsbert J.","family":"H\u00f6tte","sequence":"first","affiliation":[{"name":"Department of Oculoplastic, Lacrimal & Orbital Surgery Rotterdam Eye Hospital Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem A.","family":"Dik","sequence":"additional","affiliation":[{"name":"Laboratory Medical Immunology, Department of Immunology Erasmus MC University Medical Center Rotterdam Rotterdam the Netherlands"},{"name":"Reinier Haga Medisch Diagnostisch Centrum (RHMDC), Laboratory Medical Immunology Delft the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald O. B.","family":"de Keizer","sequence":"additional","affiliation":[{"name":"Department of Oculoplastic, Lacrimal & Orbital Surgery Rotterdam Eye Hospital Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sodaba","family":"Khatab","sequence":"additional","affiliation":[{"name":"Department of Oculoplastic, Lacrimal & Orbital Surgery Rotterdam Eye Hospital Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Medici","sequence":"additional","affiliation":[{"name":"Academic Center for Thyroid Diseases, Department of Internal Medicine Erasmus MC University Medical Center Rotterdam Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid M. A.","family":"Swagemakers","sequence":"additional","affiliation":[{"name":"Department of Pathology & Clinical Bioinformatics Erasmus MC University Medical Center Rotterdam Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"van der Spek","sequence":"additional","affiliation":[{"name":"Department of Pathology & Clinical Bioinformatics Erasmus MC University Medical Center Rotterdam Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Martin","family":"van Hagen","sequence":"additional","affiliation":[{"name":"Laboratory Medical Immunology, Department of Immunology Erasmus MC University Medical Center Rotterdam Rotterdam the Netherlands"},{"name":"Department of Internal Medicine, Section Clinical Immunology Erasmus MC University Medical Center Rotterdam Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6762-3614","authenticated-orcid":false,"given":"Dion","family":"Paridaens","sequence":"additional","affiliation":[{"name":"Department of Oculoplastic, Lacrimal & Orbital Surgery Rotterdam Eye Hospital Rotterdam the Netherlands"},{"name":"Department of Ophthalmology Erasmus MC University Medical Center Rotterdam Rotterdam the Netherlands"},{"name":"Department of Ophthalmology L'H\u00f4pital Fondation Rothschild Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"issue":"1","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1742-1241.2006.01004.x","article-title":"Comparison of intravenous methylprednisolone therapy vs. oral methylprednisolone therapy in patients with graves' ophthalmopathy","volume":"61","author":"Aktaran S.","year":"2007","journal-title":"International Journal of Clinical Practice"},{"issue":"4","key":"e_1_2_7_3_1","first-page":"461","article-title":"Validation of Indonesian graves' ophthalmopathy quality of life questionnaire and its association with clinical activity and severity of graves' ophthalmopathy","volume":"56","author":"Anggraini C.","year":"2024","journal-title":"Acta Medica Indonesiana"},{"issue":"8","key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1056\/NEJMra0905750","article-title":"Graves' ophthalmopathy","volume":"362","author":"Bahn R.S.","year":"2010","journal-title":"The New England Journal of Medicine"},{"issue":"4","key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"G43","DOI":"10.1530\/EJE-21-0479","article-title":"The 2021 European Group on Graves' Orbitopathy (EUGOGO) clinical practice guidelines for the medical management of graves' orbitopathy","volume":"185","author":"Bartalena L.","year":"2021","journal-title":"European Journal of Endocrinology"},{"issue":"12","key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"4454","DOI":"10.1210\/jc.2012-2389","article-title":"Efficacy and safety of three different cumulative doses of intravenous methylprednisolone for moderate to severe and active graves' orbitopathy","volume":"97","author":"Bartalena L.","year":"2012","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"issue":"5","key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1007\/s40618-017-0608-z","article-title":"Does early response to intravenous glucocorticoids predict the final outcome in patients with moderate\u2010to\u2010severe and active graves' orbitopathy","volume":"40","author":"Bartalena L.","year":"2017","journal-title":"Journal of Endocrinological Investigation"},{"issue":"1","key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1159\/000510700","article-title":"Proposal for standardization of primary and secondary outcomes in patients with active, moderate\u2010to\u2010severe graves' orbitopathy","volume":"9","author":"Bartalena L.","year":"2020","journal-title":"European Thyroid Journal"},{"issue":"1","key":"e_1_2_7_9_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjophth-2023-001515","article-title":"Graves' ophthalmopathy: the clinical and psychosocial outcomes of different medical interventions\u2014A systematic review","volume":"9","author":"Bello O.M.","year":"2024","journal-title":"BMJ Open Ophthalmology"},{"issue":"7","key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.autrev.2017.12.012","article-title":"Quality of life and neuropsychiatric disorders in patients with graves' orbitopathy: current concepts","volume":"17","author":"Bruscolini A.","year":"2018","journal-title":"Autoimmunity Reviews"},{"key":"e_1_2_7_11_1","unstructured":"Castor EDC. (2019)Castor Electronic Data Capture.https:\/\/castoredc.com"},{"issue":"12","key":"e_1_2_7_12_1","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1136\/bjophthalmol-2011-300487","article-title":"Validity and reliability of the TED\u2010QOL: a new three\u2010item questionnaire to assess quality of life in thyroid eye disease","volume":"95","author":"Fayers T.","year":"2011","journal-title":"The British Journal of Ophthalmology"},{"issue":"6","key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1080\/01676830.2016.1193542","article-title":"Sensitivity and responsiveness of the patient\u2010reported TED\u2010QOL to rehabilitative surgery in thyroid eye disease","volume":"35","author":"Fayers T.","year":"2016","journal-title":"Orbit"},{"issue":"6","key":"e_1_2_7_14_1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1159\/000508071","article-title":"Predictive factors for changes in quality of life after steroid treatment for active moderate\u2010to\u2010severe graves' orbitopathy: a prospective trial","volume":"9","author":"Hoppe E.","year":"2021","journal-title":"European Thyroid Journal"},{"issue":"3","key":"e_1_2_7_15_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1080\/01676830.2016.1176049","article-title":"Evaluation of quality of life in patients with graves ophthalmopathy, before and after orbital decompression","volume":"35","author":"Iacobaeus L.","year":"2016","journal-title":"Orbit"},{"issue":"4","key":"e_1_2_7_16_1","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1111\/j.1365-2265.2005.02352.x","article-title":"Psychosocial morbidity of graves' orbitopathy","volume":"63","author":"Kahaly G.J.","year":"2005","journal-title":"Clinical Endocrinology"},{"issue":"1","key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4103\/0974-9233.75884","article-title":"Change in quality of life after medical and surgical treatment of graves' ophthalmopathy","volume":"18","author":"Kashkouli M.B.","year":"2011","journal-title":"Middle East African Journal of Ophthalmology"},{"issue":"1","key":"e_1_2_7_18_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1210\/clinem\/dgad476","article-title":"A randomized clinical trial of intravenous methylprednisolone with 2 protocols in patients with graves orbitopathy","volume":"109","author":"Li Z.","year":"2023","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"issue":"8","key":"e_1_2_7_19_1","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1136\/bjo.73.8.639","article-title":"Clinical criteria for the assessment of disease activity in graves' ophthalmopathy: a novel approach","volume":"73","author":"Mourits M.P.","year":"1989","journal-title":"The British Journal of Ophthalmology"},{"issue":"1","key":"e_1_2_7_20_1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1046\/j.1365-2265.1997.2331047.x","article-title":"Clinical activity score as a guide in the management of patients with graves' ophthalmopathy","volume":"47","author":"Mourits M.P.","year":"1997","journal-title":"Clinical Endocrinology"},{"issue":"5","key":"e_1_2_7_21_1","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/01.MLR.0000062554.74615.4C","article-title":"Interpretation of changes in health\u2010related quality of life: the remarkable universality of half a standard deviation","volume":"41","author":"Norman G.R.","year":"2003","journal-title":"Medical Care"},{"issue":"1","key":"e_1_2_7_22_1","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1210\/clinem\/dgac230","article-title":"Measuring health\u2010related quality of life in thyroid eye disease","volume":"107","author":"Sharma A.","year":"2022","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"e_1_2_7_23_1","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2025.1657160","article-title":"Age\u2010dependent diagnostic and treatment response prediction of TBII and TSI in graves' orbitopathy: integration with orbital MRI biomarkers","volume":"16","author":"Song C.","year":"2025","journal-title":"Frontiers in Immunology"},{"issue":"11","key":"e_1_2_7_24_1","doi-asserted-by":"crossref","first-page":"4305","DOI":"10.1007\/s10792-023-02842-8","article-title":"Changes in therapeutic response, ocular manifestations of graves' orbitopathy and quality of life during the first year after orbital radiotherapy","volume":"43","author":"Stoynova M.A.","year":"2023","journal-title":"International Ophthalmology"},{"issue":"3","key":"e_1_2_7_25_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1046\/j.1365-2265.2001.01241.x","article-title":"Interpretation and validity of changes in scores on the graves' ophthalmopathy quality of life questionnaire (GO\u2010QOL) after different treatments","volume":"54","author":"Terwee C.B.","year":"2001","journal-title":"Clinical Endocrinology"},{"issue":"7","key":"e_1_2_7_26_1","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1136\/bjo.82.7.773","article-title":"Development of a disease specific quality of life questionnaire for patients with graves' ophthalmopathy: the GO\u2010QOL","volume":"82","author":"Terwee C.B.","year":"1998","journal-title":"The British Journal of Ophthalmology"},{"issue":"9","key":"e_1_2_7_27_1","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1089\/thy.2014.0037","article-title":"What are the psychosocial outcomes of treatment for thyroid eye disease? A systematic review","volume":"24","author":"Wickwar S.","year":"2014","journal-title":"Thyroid"},{"issue":"2","key":"e_1_2_7_28_1","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1089\/thy.2021.0411","article-title":"The effect of ophthalmic surgery for graves' orbitopathy on quality of life: a systematic review and meta\u2010analysis","volume":"32","author":"Woo T.","year":"2022","journal-title":"Thyroid"}],"container-title":["Acta Ophthalmologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.70199","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aos.70199","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.70199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T19:09:45Z","timestamp":1784833785000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aos.70199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":27,"alternative-id":["10.1111\/aos.70199"],"URL":"https:\/\/doi.org\/10.1111\/aos.70199","archive":["Portico"],"relation":{},"ISSN":["1755-375X","1755-3768"],"issn-type":[{"value":"1755-375X","type":"print"},{"value":"1755-3768","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]},"assertion":[{"value":"2026-04-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"aos.70199"}}