Gunay Murat, Celik Gokhan, Yildiz Elvin, Bardak Handan, Kirmizibekmez Heves, Koc Nermin, Gunay Betul Onal
Department of Ophthalmology, Trabzon Fatih State Hospital, Trabzon, Turkey.
Department of Ophthalmology, Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Istanbul, Turkey.
Arq Bras Oftalmol. 2019 Jul-Aug;82(4):283-288. doi: 10.5935/0004-2749.20190056. Epub 2019 Apr 8.
We aimed to assess ocular surface characteristics in children with Hashimoto's thyroiditis without thyroid-associated ophthalmopathy and compare the results with those of healthy children.
Twenty-two children with Hashimoto's thyroiditis (Group 1) and 20 healthy children without any ocular and/or systemic disorder (Group 2) were enrolled in the study. Ocular Surface Disease Index questionnaire, tear film osmolarity measurement (TearLab Osmolarity System, San Diego, CA, USA), Schirmer and tear film breakup time tests, meibography, and conjunctival brush cytology were performed and compared the results between the groups.
The study group included 19 girls and 3 boys in Group 1 and 12 girls and 8 boys in Group 2 (p=0.081). Thyroid-associated ophthalmopathy was not identified in any of the patients. Mean tear film osmolarity was 310.23 ± 11.98 mOsm/l in Group 1 and 313.60 ± 15.03 mOsm/l in Group 2 (p=0.424). Mean Schirmer test score was lower in Group 1 (14.91 ± 6.27) compared with Group 2 (23.60 ± 5.63) (p=0.001). Mean tear film breakup time was lower in Group 1 (11.78 ± 4.07) compared with Group 2 (15.1 ± 1.6) (p=0.013). Moreover, mean meibomian gland area loss was 25.01% ± 10.04% in Group 1 and 16.54% ± 6.02% in Group 2 (p=0.002). Conjunctival cytologic analysis in Group 1 revealed grade 0 changes in 6 patients (27.3%), grade 1 changes in 14 patients (63.6%), and grade 2 changes in 2 patients (9.1%), whereas 18 patients (90%) had grade 0 changes and 2 patients (10%) had grade 1 changes (p=0.001) in Group 2.
The study demonstrates several ocular surface changes in children with Hashimoto's thyroiditis. These findings may indicate a tendency for dry eye in pediatric Hashimoto's thyroiditis patients without clinical evidence of thyroid-associated ophthalmopathy.
我们旨在评估无甲状腺相关眼病的桥本甲状腺炎患儿的眼表特征，并将结果与健康儿童进行比较。
本研究纳入了22例桥本甲状腺炎患儿（第1组）和20例无任何眼部和/或全身疾病的健康儿童（第2组）。进行了眼表疾病指数问卷调查、泪膜渗透压测量（美国加利福尼亚州圣地亚哥市的TearLab渗透压系统）、泪液分泌试验和泪膜破裂时间测试、睑板腺照相以及结膜刷片细胞学检查，并比较了两组之间的结果。
研究组中，第1组有19名女孩和3名男孩，第2组有12名女孩和8名男孩（p = 0.081）。所有患者均未发现甲状腺相关眼病。第1组的平均泪膜渗透压为310.23±11.98 mOsm/l，第2组为313.60±15.03 mOsm/l（p = 0.424）。第1组的平均泪液分泌试验评分（14.91±6.27）低于第2组（23.60±5.63）（p = 0.001）。第1组的平均泪膜破裂时间（11.78±4.07）低于第2组（15.1±1.6）（p = 0.013）。此外，第1组睑板腺面积平均损失为25.01%±10.04%，第2组为16.54%±6.02%（p = 0.002）。第1组结膜细胞学分析显示，6例患者（27.3%）为0级改变，14例患者（63.6%）为1级改变，2例患者（9.1%）为2级改变，而第2组18例患者（90%）为0级改变，2例患者（10%）为1级改变（p = 0.001）。
该研究表明桥本甲状腺炎患儿存在多种眼表改变。这些发现可能表明在无甲状腺相关眼病临床证据的儿童桥本甲状腺炎患者中存在干眼倾向。
