Liao Xulin, Aljufairi Fatema Mohamed Ali Abdulla, Lai Kenneth Ka Hei, Chan Karen Kar Wun, Jia Ruofan, Chen Wanxue, Hu Zhichao, Wei Yingying, Chu Winnie Chiu Wing, Tham Clement Chee Yung, Pang Chi Pui, Chong Kelvin Kam Lung
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
Department of Ophthalmology, Salmaniya Medical Complex, Government Hospitals, Manama 435, Bahrain.
J Clin Med. 2023 Mar 15;12(6):2284. doi: 10.3390/jcm12062284.
To elucidate the clinical implications of corneal striae (CS) in thyroid associated orbitopathy (TAO) patients.
In this cross-sectional study, the presence of CS was confirmed after topical fluorescein staining on a slit lamp for consecutive treatment-naive TAO patients. Orbital parameters, including margin reflex distances, lagophthalmos, exophthalmos, intraocular pressure and radiological measurements, were compared between eyes with and without CS. The largest cross-sectional areas of each rectus muscle were measured by segmenting the T1-weighted (T1W) magnetic resonance images (MRI). The logistic regression analyses were used to evaluate the associations between CS and orbital parameters and rectus muscle measurements.
Fifty-three consecutive TAO patients (presenting age 46.47 ± 14.73 years, clinical activity score 1.77 ± 1.25) who had unilateral CS were enrolled. In univariate analysis, both the degree of lagophthalmos and the area of the levator palpebrae superioris-superior rectus complex (LPS/SR) on T1W MRI were significantly larger in CS eyes compared to eyes without CS ( < 0.05). Multivariate analyses showed that CS in TAO patients were significantly associated with the degree of lagophthalmos (OR = 1.75, 95% CI: 1.18-2.61, < 0.05) and LPS/SR area (OR = 19.27, 95% CI: 1.43-259.32, < 0.05) but not with the other parameters. CS could predict LPS/SR enlargement and larger lagophthalmos in TAO ( < 0.05). The largest cross-sectional areas of LPS/SR and inferior rectus were positively correlated with clinical activity scores ( < 0.05).
The presence of CS in TAO eye is significantly associated with LPS/SR enlargement and worse lagophthalmos. CS might be evaluated further as a potential ocular surface biomarker to identify upper lid and LPS/SR involvement in TAO.
阐明角膜条纹（CS）在甲状腺相关性眼病（TAO）患者中的临床意义。
在这项横断面研究中，对连续的未经治疗的TAO患者在裂隙灯下进行局部荧光素染色后确认CS的存在。比较有CS和无CS的眼睛之间的眼眶参数，包括边缘反射距离、兔眼、眼球突出、眼压和影像学测量。通过分割T1加权（T1W）磁共振图像（MRI）测量每条直肌的最大横截面积。采用逻辑回归分析评估CS与眼眶参数及直肌测量值之间的关联。
纳入53例单侧有CS的连续TAO患者（年龄46.47±14.73岁，临床活动评分1.77±1.25）。单因素分析显示，与无CS的眼睛相比，有CS的眼睛兔眼程度和T1W MRI上提上睑肌-上直肌复合体（LPS/SR）面积均显著更大（P<0.05）。多因素分析显示，TAO患者的CS与兔眼程度（OR=1.75，95%CI：1.18-2.61，P<0.05）和LPS/SR面积（OR=19.27，95%CI：1.43-259.32，P<0.05）显著相关，但与其他参数无关。CS可预测TAO患者LPS/SR增大和兔眼程度加重（P<0.05）。LPS/SR和下直肌的最大横截面积与临床活动评分呈正相关（P<0.05）。
TAO眼中CS的存在与LPS/SR增大和更严重的兔眼显著相关。CS可能作为一种潜在的眼表生物标志物进一步评估，以识别TAO中眼睑和LPS/SR受累情况。
