Gatzioufas Z, Thanos S
Department of Experimental Ophthalmology, University Eye Hospital Muenster, Muenster, Germany.
J Endocrinol Invest. 2008 Mar;31(3):262-6. doi: 10.1007/BF03345600.
Keratoconus is a bilateral non-inflammatory corneal ectasia with an incidence of approximately 1 per 2000 in the general population. The etiology of keratoconus is multifactorial, although not completely understood. Several clinical observations suggest that thyroid gland dysfunction is associated with keratoconus pathophysiology. Pregnancy represents a major alteration in the maternal endocrinologic status characterized by modified function of the thyroid gland. We report on a 33-yr-old pregnant women suffering from keratoconus, who presented simultaneously with a remarkable deterioration of the disease during gestation and with thyroid gland dysfunction. Acute keratoconus in this patients coincided with the lowest plasma T4 level reached during pregnancy. During the third trimester of gestation, the keratoconus receded significantly. Here we provide direct evidence in support of a possible linkage between keratoconus and thyroid gland dysfunction, assumed by previous clinical observations. This case report is the first to suggest that changes in maternal thyroid hormone levels during pregnancy can aggravate the progression of keratoconus.
圆锥角膜是一种双侧非炎性角膜扩张症，在普通人群中的发病率约为每2000人中有1例。圆锥角膜的病因是多因素的，尽管尚未完全明确。一些临床观察表明，甲状腺功能障碍与圆锥角膜的病理生理学有关。妊娠代表了母体内分泌状态的重大改变，其特征是甲状腺功能发生改变。我们报告了一名33岁患有圆锥角膜的孕妇，她在妊娠期同时出现了病情的显著恶化以及甲状腺功能障碍。该患者的急性圆锥角膜发作与孕期达到的最低血浆T4水平同时出现。在妊娠晚期，圆锥角膜明显消退。我们在此提供直接证据，支持先前临床观察所推测的圆锥角膜与甲状腺功能障碍之间可能存在的联系。本病例报告首次表明，孕期母体甲状腺激素水平的变化会加重圆锥角膜的进展。
