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Peer-reviewedCC BY-NC-ND 4.0BMC Ophthalmology

Sex-related disparities in patient-reported quality of life in thyroid eye disease: a domain-specific GO-QOL analysis

  • Alessandro Gaeta1
  • Alessandra Di Maria2,3
  • Silvia Ferraro4
  • Noemi Sasso1
  • Alberto Zanchi2,3
  • Filippo Lixi5
  • Alberto Cuccu5
  • Giulia Lanzolla6
  • Giuseppe Giannaccare5
6 affiliations
  1. 1Department of Internal Medicine and Medical Specialties (DIMI), Università di Genova, Viale Benedetto XV, Genova, Italy
  2. 2Department of Ophthalmology, IRCCS Humanitas Research Hospital, Rozzano, Milan Italy
  3. 3Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
  4. 4Department of Ophthalmology, University of Catania, Via S. Sofia 78, Catania, Italy
  5. 5Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
  6. 6Endocrinology Unit, Department of Medical Science, University of Cagliari, Cagliari, Italy
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Abstract

Background: Thyroid eye disease (TED) is associated with substantial functional and psychosocial burden, but the independent association between sex and patient-reported quality of life remains incompletely understood. This study assessed sex-related differences in the visual-functioning and appearance-related domains of the Graves’ Ophthalmopathy Quality of Life questionnaire (GO-QOL).

Methods: This retrospective cross-sectional study included 144 consecutive patients with TED evaluated at a tertiary referral center. The cohort comprised 61 men and 83 women, with a mean age of 54.8 ± 10.2 years. All patients completed the GO-QOL questionnaire during the same clinical visit as a standardized ophthalmic and endocrine assessment. Separate multivariable linear regression models were constructed for the two GO-QOL domains, adjusting for age, TED duration, Clinical Activity Score, exophthalmos, diplopia severity, smoking status, and thyroid functional status.

Results: Women had lower unadjusted GO-QOL scores than men in both the visual-functioning domain (85.3 ± 17.7 vs. 93.4 ± 11.1; p = 0.004) and the appearance-related domain (87.6 ± 14.8 vs. 96.1 ± 3.5; p = 0.020). After multivariable adjustment, female sex remained independently associated with lower scores in the visual-functioning domain (β = −4.22; 95% CI, − 7.33 to − 1.11; p = 0.008) and the appearance-related domain (β = −6.60; 95% CI, − 9.30 to − 3.90; p < 0.001). TED duration was not independently associated with either GO-QOL domain. Diplopia severity and hyperthyroid status were strongly associated with lower scores in both domains. Exophthalmos was also independently associated with lower visual-functioning and appearance-related GO-QOL scores.

Conclusions: Female sex was independently associated with lower GO-QOL scores in both domains, with a larger association in the appearance-related domain. These findings indicate that conventional clinical measures may not fully capture patient-perceived disease burden and support the integration of disease-specific patient-reported outcomes into routine TED assessment.

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Cite

BibTeXRIS
BibTeX
@article{gaeta2026sexrelated,
  title = {{Sex-related disparities in patient-reported quality of life in thyroid eye disease: a domain-specific GO-QOL analysis}},
  author = {Alessandro Gaeta and Alessandra Di Maria and Silvia Ferraro and Noemi Sasso and Alberto Zanchi and Filippo Lixi and Alberto Cuccu and Giulia Lanzolla and Giuseppe Giannaccare},
  journal = {BMC Ophthalmology},
  year = {2026},
  month = aug,
  doi = {10.1186/s12886-026-05219-4},
  url = {https://doi.org/10.1186/s12886-026-05219-4},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Sex-related disparities in patient-reported quality of life in thyroid eye disease: a domain-specific GO-QOL analysis
AU  - Alessandro Gaeta
AU  - Alessandra Di Maria
AU  - Silvia Ferraro
AU  - Noemi Sasso
AU  - Alberto Zanchi
AU  - Filippo Lixi
AU  - Alberto Cuccu
AU  - Giulia Lanzolla
AU  - Giuseppe Giannaccare
PY  - 2026
DA  - 2026/08/08
JO  - BMC Ophthalmology
DO  - 10.1186/s12886-026-05219-4
UR  - https://doi.org/10.1186/s12886-026-05219-4
AB  - Background: Thyroid eye disease (TED) is associated with substantial functional and psychosocial burden, but the independent association between sex and patient-reported quality of life remains incompletely understood. This study assessed sex-related differences in the visual-functioning and appearance-related domains of the Graves’ Ophthalmopathy Quality of Life questionnaire (GO-QOL).  Methods: This retrospective cross-sectional study included 144 consecutive patients with TED evaluated at a tertiary referral center. The cohort comprised 61 men and 83 women, with a mean age of 54.8 ± 10.2 years. All patients completed the GO-QOL questionnaire during the same clinical visit as a standardized ophthalmic and endocrine assessment. Separate multivariable linear regression models were constructed for the two GO-QOL domains, adjusting for age, TED duration, Clinical Activity Score, exophthalmos, diplopia severity, smoking status, and thyroid functional status.  Results: Women had lower unadjusted GO-QOL scores than men in both the visual-functioning domain (85.3 ± 17.7 vs. 93.4 ± 11.1; p = 0.004) and the appearance-related domain (87.6 ± 14.8 vs. 96.1 ± 3.5; p = 0.020). After multivariable adjustment, female sex remained independently associated with lower scores in the visual-functioning domain (β = −4.22; 95% CI, − 7.33 to − 1.11; p = 0.008) and the appearance-related domain (β = −6.60; 95% CI, − 9.30 to − 3.90; p < 0.001). TED duration was not independently associated with either GO-QOL domain. Diplopia severity and hyperthyroid status were strongly associated with lower scores in both domains. Exophthalmos was also independently associated with lower visual-functioning and appearance-related GO-QOL scores.  Conclusions: Female sex was independently associated with lower GO-QOL scores in both domains, with a larger association in the appearance-related domain. These findings indicate that conventional clinical measures may not fully capture patient-perceived disease burden and support the integration of disease-specific patient-reported outcomes into routine TED assessment.
SN  - 1471-2415
ER  -