Status of Ocular Surface in Thyrotoxicosis
Eman Mahmoud Ahmed;
Abstract
This study was done in atrial to answer a common question about the effect of thyrotoxicosis on the ocular surface.
Thyrotoxicosis, which results from the biochemical and physiologic effects of excess thyroid hormone regardless of cause, is one of the more common endocrine disorders.
The most common cause of thyrotoxicosis is GD, in which autoantibodies bind to and stimulate the TSH receptors found on the surface of thyroid follicular cells, which results in excess production of T3 and T4. The next most common cause is autonomous overproduction of thyroid hormones by one (solitary toxic adenoma) or more (toxic multinodular goiter) nodules within the thyroid (secondary thyrotoxicosis).
The prevalence and incidence of thyroid disorders is influenced primarily by sex and age. Thyroid disorders are more common in women than men, and in older adults compared with younger age groups.
Our study was done on an objectivebases, 40 eyes of 20 patients divided into two groups (Graves' disease and 2ry thyrotoxicosis) were compared to 10 eyes of 5 healthy individuals.
The study conducted from June 2014 to June 2015 as a prospective cross sectional study.
Examination included tear film break up time, impression cytology and exophthalmos measurement.
Regarding the TFBUTshowed highly significant defective tear film stability in the cases groups as compared to the age matched control group.
This result showed statistically significant difference between group (I) and control as regard normal and mild exophthalmos.
IC is a very useful and reliable method of obtaining a histological view of the ocular surface status indicated by the grades of squamous metaplasia.
The results of IC of the first group (Graves') showed that 14 eyes out of 20 (70%) had grade 2–3 squamous metaplasia. The results shows statistically significant difference between group (I) and control as regard impression cytology grade.
The results of IC of the second group (2ry thyrotoxicosis) showed that 6 eyes out of 20 (30%) with grade two or higher squamous metaplasia denoting ocular surface affection.
No significant correlation were found between the onset timing of thyrotoxicosis symptoms and IC indicating that ocular surface affection in thyrotoxicosis is related to the presence of the disease and not the duration.
Correlation analysis between different diagnostic tests revealed that the changes of the ocular surface indicated by the changes in the conjunctival IC in GDhave a direct correlation with each of TFBUT, exophthalmos and disease severity. It showed non-significant correlation with duration of disease.
Correlation analysis between different diagnostic tests revealed that the changes of the ocular surface indicated by the changes in the conjunctival IC in 2ry thyrotoxicosis disease have a direct correlation with TFBUT. It showed non-significant correlation with duration of disease and exophthalmos.
In conclusion, the results drawn from this study are in accordance with many but not all the previous studies in the last decade. These differences may be attributed to environmental, infectious or genetic factors that not have been studied yet.
Thyrotoxicosis, which results from the biochemical and physiologic effects of excess thyroid hormone regardless of cause, is one of the more common endocrine disorders.
The most common cause of thyrotoxicosis is GD, in which autoantibodies bind to and stimulate the TSH receptors found on the surface of thyroid follicular cells, which results in excess production of T3 and T4. The next most common cause is autonomous overproduction of thyroid hormones by one (solitary toxic adenoma) or more (toxic multinodular goiter) nodules within the thyroid (secondary thyrotoxicosis).
The prevalence and incidence of thyroid disorders is influenced primarily by sex and age. Thyroid disorders are more common in women than men, and in older adults compared with younger age groups.
Our study was done on an objectivebases, 40 eyes of 20 patients divided into two groups (Graves' disease and 2ry thyrotoxicosis) were compared to 10 eyes of 5 healthy individuals.
The study conducted from June 2014 to June 2015 as a prospective cross sectional study.
Examination included tear film break up time, impression cytology and exophthalmos measurement.
Regarding the TFBUTshowed highly significant defective tear film stability in the cases groups as compared to the age matched control group.
This result showed statistically significant difference between group (I) and control as regard normal and mild exophthalmos.
IC is a very useful and reliable method of obtaining a histological view of the ocular surface status indicated by the grades of squamous metaplasia.
The results of IC of the first group (Graves') showed that 14 eyes out of 20 (70%) had grade 2–3 squamous metaplasia. The results shows statistically significant difference between group (I) and control as regard impression cytology grade.
The results of IC of the second group (2ry thyrotoxicosis) showed that 6 eyes out of 20 (30%) with grade two or higher squamous metaplasia denoting ocular surface affection.
No significant correlation were found between the onset timing of thyrotoxicosis symptoms and IC indicating that ocular surface affection in thyrotoxicosis is related to the presence of the disease and not the duration.
Correlation analysis between different diagnostic tests revealed that the changes of the ocular surface indicated by the changes in the conjunctival IC in GDhave a direct correlation with each of TFBUT, exophthalmos and disease severity. It showed non-significant correlation with duration of disease.
Correlation analysis between different diagnostic tests revealed that the changes of the ocular surface indicated by the changes in the conjunctival IC in 2ry thyrotoxicosis disease have a direct correlation with TFBUT. It showed non-significant correlation with duration of disease and exophthalmos.
In conclusion, the results drawn from this study are in accordance with many but not all the previous studies in the last decade. These differences may be attributed to environmental, infectious or genetic factors that not have been studied yet.
Other data
| Title | Status of Ocular Surface in Thyrotoxicosis | Other Titles | حالة سطح العين فى مرض تسمم الغدة الدرقية | Authors | Eman Mahmoud Ahmed | Issue Date | 2015 |
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