Instituto de Oftalmologia Conde de Valenciana, IAP, Chimalpopoca # 14, Colonia Obrera, Delegación Cuauhtemoc, 06800, Mexico City, Mexico.
Instituto de Oftalmologia Conde de Valenciana, IAP, Chimalpopoca # 14, Colonia Obrera, Delegación Cuauhtemoc, 06800, Mexico City, Mexico.
J Fr Ophtalmol. 2021 May;44(5):643-651. doi: 10.1016/j.jfo.2020.08.029. Epub 2021 Apr 15.
Graves' orbitopathy (GO) is the most common extrathyroidal manifestation of Graves' disease (GD), an autoimmune disorder arising from the activity of T lymphocytes against antigens that infiltrate thyroid tissue, orbital tissue and extraocular muscles. An increase in oxidative stress has been discovered in autoimmune thyroid disease, encouraging investigation into new forms of treatment. Selenium has been described as a treatment option given its antioxidant properties. The present study evaluates the decrease of progression and inflammatory signs in patients with mild GO with oral selenium supplementation.
Controlled, randomized, single center trial at an ophthalmology referral center in Mexico City. Patients at least 18years of age with mild GO according to the CAS classification were included; exclusion criteria in addition to corticosteroid treatment included smokers or selenium allergy. Each patient was randomized into one of two groups. Group A took placebo tablets which consisted of 100μg of starch twice a day for 6months, and group B took a 100μg selenium tablet twice a day for 6months. The patients from both groups were examined and evaluated using a CAS score before and after the first, third and sixth month of treatment.
Thirty eyes of 30 patients were studied. The pretreatment values showed no statistically significant differences between groups (P>0.05). Intergroup analysis showed statistically significant differences in palpebral fissure and CAS score between the pretreatment values and six months after treatment in the selenium group (P<0.05). No differences were found in any variables in the placebo group during the study period (P>0.05). No adverse events were reported.
This is the first study in a Mexican population demonstrating that oral selenium decreases clinical activity and stops progression in patients with mild GO.
Graves 眼病（GO）是 Graves 病（GD）最常见的甲状腺外表现，这是一种自身免疫性疾病，源于 T 淋巴细胞针对浸润甲状腺组织、眼眶组织和眼外肌的抗原的活性。在自身免疫性甲状腺疾病中发现氧化应激增加，这促使人们研究新的治疗方法。硒因其抗氧化特性而被描述为一种治疗选择。本研究评估了口服硒补充剂对轻度 GO 患者疾病进展和炎症标志物的降低作用。
在墨西哥城的一家眼科转诊中心进行的对照、随机、单中心试验。纳入年龄至少 18 岁且根据 CAS 分类为轻度 GO 的患者；除皮质类固醇治疗外，排除标准还包括吸烟者或硒过敏。每位患者随机分为两组。A 组服用安慰剂片剂，每天两次，每次 100μg 淀粉，持续 6 个月，B 组每天两次服用 100μg 硒片剂，持续 6 个月。两组患者在治疗前、治疗后第 1、3 和 6 个月接受 CAS 评分检查和评估。
30 名患者的 30 只眼睛接受了研究。治疗前值两组间无统计学显著差异（P＞0.05）。组间分析显示，硒组治疗前值与治疗后 6 个月时的睑裂和 CAS 评分有统计学显著差异（P＜0.05）。在研究期间，安慰剂组的任何变量均无差异（P＞0.05）。未报告任何不良事件。
这是墨西哥人群中第一项研究，表明口服硒可降低轻度 GO 患者的临床活动度并阻止疾病进展。
