Department of Ophthalmology (M.A.E., S.K.U., E.D.E.), Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey ; and Department of Endocrinology and Metabolism (G.G.O.), Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
Eye Contact Lens. 2021 Jan 1;47(1):32-37. doi: 10.1097/ICL.0000000000000686.
We sought to evaluate ocular surface changes in patients with Hashimoto's thyroiditis without thyroid ophthalmopathy and elucidate the relationship between dry eye syndrome and meibomian gland dysfunction (MGD) in cases of Hashimoto's thyroiditis.
This prospective study included 105 patients with Hashimoto's thyroiditis and 105 age- and sex-matched controls. The 12-item Ocular Surface Disease Index (OSDI) questionnaire was administered to all patients. Both eyes affected by Hashimoto's thyroiditis and normal eyes were evaluated and compared with regard to the following parameters: Hertel exophthalmometry, palpebral fissure height, tear-film breakup time (TBUT), Schirmer 1 test, area and density scores for corneal fluorescein staining, eyelid abnormality, meibomian gland expression, meibography scores, and areas of meibomian gland loss.
The eyes affected by Hashimoto's thyroiditis demonstrated significantly lower TBUTs (P<0.001), Schirmer 1 test scores (P<0.001), and meibomian gland expression (P<0.05) and significantly higher OSDI scores (P<0.001), corneal fluorescein staining results (P<0.05), eyelid abnormality scores (P<0.05), meibography scores (P<0.05), and areas of meibomian gland loss (P<0.05). Ocular Surface Disease Index scores were significantly positively correlated with eyelid abnormality scores (P=0.025), meibography scores (P<0.05), and areas of meibomian gland loss (P<0.05) and negatively correlated with meibomian gland expression (P<0.05). The duration of Hashimoto's thyroiditis was significantly positively correlated with MGD (P<0.05).
Dry eye syndrome and ocular discomfort symptoms are significantly more common among patients with Hashimoto's thyroiditis, even in the absence of thyroid ophthalmopathy. Dry eye syndrome in patients with Hashimoto's thyroiditis is believed to result from MGD and is correlated with the duration of the thyroid disease.
我们旨在评估无甲状腺眼病的桥本甲状腺炎患者的眼表变化，并阐明桥本甲状腺炎患者干眼综合征与睑板腺功能障碍（MGD）之间的关系。
这项前瞻性研究纳入了 105 例桥本甲状腺炎患者和 105 例年龄和性别匹配的对照者。所有患者均接受 12 项眼表疾病指数（OSDI）问卷评估。对桥本甲状腺炎受累眼和正常眼进行评估，并比较以下参数：Hertel 突眼计、睑裂高度、泪膜破裂时间（TBUT）、Schirmer 1 试验、角膜荧光素染色的面积和密度评分、眼睑异常、睑板腺分泌、睑板腺照相评分和睑板腺缺失面积。
桥本甲状腺炎受累眼的 TBUT（P<0.001）、Schirmer 1 试验评分（P<0.001）和睑板腺分泌（P<0.05）显著降低，而 OSDI 评分（P<0.001）、角膜荧光素染色结果（P<0.05）、眼睑异常评分（P<0.05）、睑板腺照相评分（P<0.05）和睑板腺缺失面积（P<0.05）显著增加。OSDI 评分与眼睑异常评分（P=0.025）、睑板腺照相评分（P<0.05）和睑板腺缺失面积（P<0.05）显著正相关，与睑板腺分泌呈显著负相关（P<0.05）。桥本甲状腺炎的病程与 MGD 呈显著正相关（P<0.05）。
即使没有甲状腺眼病，桥本甲状腺炎患者也更常出现干眼综合征和眼部不适症状。桥本甲状腺炎患者的干眼综合征被认为是由 MGD 引起的，并且与甲状腺疾病的病程相关。
