Glomaud J, Liotet S
Laboratoire de Biologie médicale, Hôpital des Quinze-Vingts, Paris.
J Fr Ophtalmol. 1987;10(11):639-45.
In the control subject, the thyroidal hormones have been found to be always present in similar quantities in both eyes tears. The proportion of T3 is much more important in the tears (23-40%) than in the plasma (1-2%). It is close to the concentration of deiodinated T4 found in many tissues. In ocular tissues, the T3 is thus very little or even not broken down. This led us to define the tear plasma relationship parameters. We studied lacrimo-plasmatic thyroidal parameters in cases with thyroidal dysfunction without ocular affection: 3 cases of hyperthyroidism, and 2 of hypothyroidism, to study modifications in case of endocrinal problems only. We also studied various types of exophthalmos: 31 cases of endocrine exophthalmos, whether the thyroidal plasma values were normal or not, and 2 cases of exophthalmia with expansive orbital hyperplasia in which there had been no previous thyroidal disturbance. An exophthalmia patient studied, including those with expansive orbital tissue, important changes, specific enough were associated in the tear/plasma parameters, correlated with the changes in the retro-orbital muscular tissues or fat detected by scanning. The study of these parameters, lacrimal thyroid is thus interesting for the diagnosis of endocrine exophthalmos and shows that only a local modification of the metabolism of T3 and T4, mainly from deiodination , process is probably implied in the pathology of these exophthalmos.
在对照受试者中，已发现甲状腺激素在双眼泪液中的含量始终相似。泪液中T3的比例（23%-40%）比血浆中（1%-2%）重要得多。它接近许多组织中脱碘T4的浓度。因此，在眼组织中，T3很少甚至不会分解。这使我们定义了泪液与血浆的关系参数。我们研究了甲状腺功能异常但无眼部病变的患者的泪液-血浆甲状腺参数：3例甲状腺功能亢进症患者和2例甲状腺功能减退症患者，仅研究内分泌问题时的变化。我们还研究了各种类型的眼球突出症：31例内分泌性眼球突出症患者，无论其甲状腺血浆值是否正常，以及2例眼眶增生性眼球突出症患者，这些患者既往无甲状腺功能紊乱。对一名眼球突出症患者进行研究，包括那些眼眶组织增生的患者，泪液/血浆参数出现了足够特异性的重要变化，这些变化与通过扫描检测到的眶后肌肉组织或脂肪的变化相关。因此，泪液甲状腺参数的研究对于内分泌性眼球突出症的诊断很有意义，并且表明在这些眼球突出症的病理过程中，可能仅涉及T3和T4代谢的局部改变，主要是脱碘过程。
