Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.
Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, South Korea.
Sci Rep. 2020 Mar 25;10(1):5399. doi: 10.1038/s41598-020-62451-8.
Patients with acquired adult-onset strabismus mainly present with binocular diplopia. Although cranial nerve palsies are reportedly the most common cause of binocular diplopia in adults, thyroid disease can also cause diplopia. In patients with thyroid-associated ophthalmopathy, upper lid retraction and proptosis are the most common initial findings, but diplopia could be the first manifestation. So far, there has been little information on the diagnostic value of thyroid autoantibodies in patients with strabismus. Therefore, we examined adults with acquired binocular diplopia from 2008 to 2016 and evaluated the presence of thyroid autoantibodies and the relationship between thyroid autoantibody status and clinical characteristics in adults with acquired binocular diplopia. Thyroid autoantibody tests were performed for all patients, unless other causes of diplopia were identified. Fifty one (39%) of 132 patients were positive for thyroid autoantibodies. In the thyroid autoantibody-positive (TAb+) group, microsomal autoantibodies, thyroid-stimulating hormone receptor antibodies, thyroglobulin antibodies, and thyroid-stimulating antibodies were observed in 30, 27, 12, and 7 patients, respectively. The vertical deviation and grade of duction limitation were greater in the TAb+ group. The presence of ocular torsion was 15.5% and 39.5% in the TAb- and TAb+ groups, respectively. Thyroid autoantibody evaluation may be helpful in adults with idiopathic acquired binocular diplopia.
后天性成人获得性斜视患者主要表现为复视。虽然颅神经麻痹据报道是成人复视最常见的原因，但甲状腺疾病也可导致复视。在甲状腺相关眼病患者中，上睑退缩和眼球突出是最常见的初始表现，但复视可能是首发表现。到目前为止，关于甲状腺自身抗体在斜视患者中的诊断价值的信息很少。因此，我们检查了 2008 年至 2016 年患有后天性双眼复视的成年人，并评估了后天性双眼复视成年人中甲状腺自身抗体的存在以及甲状腺自身抗体状态与临床特征之间的关系。对所有患者进行了甲状腺自身抗体检查，除非发现其他复视原因。在 132 名患者中，有 51 名（39%）甲状腺自身抗体阳性。在甲状腺自身抗体阳性（TAb+）组中，分别有 30、27、12 和 7 例患者出现微粒体自身抗体、促甲状腺激素受体抗体、甲状腺球蛋白抗体和促甲状腺抗体。TAb+组的垂直偏斜和下转受限程度更大。在 TAb-和 TAb+组中，眼扭转的发生率分别为 15.5%和 39.5%。甲状腺自身抗体评估可能对特发性后天性双眼复视的成年人有帮助。
