- Visibility 48 Views
- Downloads 63 Downloads
Dry eye evaluation in thyroid associated orbitopathy
- Author Details:
-
Syed Ali Raza Rizvi
-
Vinod Rana
-
Sheelu *
-
Shafiq Siddiqi
-
Veena Maheshwari
-
Yogesh Gupta
Introduction: Many systemic autoimmune diseases are associated with dry eye; the autoimmune thyroid diseases are among them. One of the leading causes of ocular surface damage in thyroid associated orbitopathy (TAO) is dry eye syndrome (DES).
Aim: To evaluate the incidence and risk factors of dry eye and associated conjunctival morphological changes in TAO.
Materials and Methods: This is a cross sectional, non-interventional, non-comparative, observational study includes thirty patients (60 eyes) of clinically diagnosed TAO. The tear film and ocular surface were evaluated using the Schirmer- I test, Tear film break-up time (TBUT), Lissamine green staining and conjunctival impression cytology.
Results: Dry eye were found in 35 (58%) eyes based on dry eye severity grading scheme (DEWS). Positive vital staining with Lissamine green was observed in 36 (60.0%) eyes. The average degree of staining was 4.28±3.81 (National Eye Institute Workshop grading system). The abnormal impression cytology was observed in 30 eyes (50.0%) of 18 patients. Impression cytology revealed the following changes: significant epithelial dystrophy with cell polymorphism, goblet cells deficiency or absence, excessive desquamation and epithelial keratinization with local leukocytic infiltration.
Conclusion: Significant risk factors of ocular surface damage in TAO were exophthalmos, palpebral fissure height, upper lid retraction, lower lid retraction and lagophthalmos. Histopathologic changes detected in conjunctiva are consistent with dry eye but were not specific for TAO.
Keywords: Dry Eye Syndrome, Impression cytology, Lissamine Green staining, Thyroid Associated Orbitopathy
References
- O’Brien PD, Collum LM. Dry eye: Diagnosis and current treatment strategies. Curr Allergy Asthma Rep 2004;4:314-9.
- Caturegli P, Kimura H, Rocchi R, et al. Autoimmune thyroid diseases. Curr Opin Rheumatol 2007;19:44–48.
- Gürdal C, Saraç O, Genç I, Kırımlıoğlu H, Takmaz T, Can I. Ocular surface and dry eye in Graves’ disease. Curr Eye Res. 2011;36(1):8–13.
- Nowak M, Marek B, Kos-Kudla B, et al. Tear film profile in patients with active thyroid orbitopathy. Klin Oczna. 2005;107:479–482.
- Eckstein AK, Finkenrath A, Heiligenhaus A, et al. Dry eye syndrome in thyroid-associated ophthalmopathy: lacrimal expression of TSH receptor -specific autoantibodies. Acta Ophthalmol Scand 2004;82:291–
- Gilbard JP, Farris RL. Ocular surface drying and ocular tear film osmolarity in thyroid eye disease. Acta Ophthalmol (Copenh) 1983;61:108–116.
- Khalil HA, De Keizer RJ, Kiljstra A. Secretory IgA and Lysozyme in tears of patients with Graves’ophthalmopathy.Doc Ophthalmol1989;72:329–
- Khurana AK, Sunder S, Ahluwalia BK, Malhotra KC. Tear film profile in Grave’s ophthalmopathy. Acta Ophthalmol (Copenh) 1992;70:346–349.
- Wiersinga WM, Perros P, Kahaly GJ, Mourits MP, Baldeschi L, Boboridis K, Boschi A, Dickinson AJ, Kendall-Taylor P, Krassas GE, Lane CM, Lazarus JH, Marcocci C, Marino` M, Neoh C, Orgiazzi J, Pinchera A, Pitz S, Prummel MF, Sartini MS, Stahl M & von Arx G. Clinical assessment of patients with Graves’ orbitopathy: the European Group on Graves’ Orbitopathy recommendations to generalists, specialists and clinical researchers. European Journal of Endocrinology 2006; 155;387–389.
- Perros P, Baldeschi L, Boboridis K, Dickinson AJ, Hullo A, Kahaly GJ, Kendall-Taylor P, Krassas GE, Lane CM, Lazarus JH, Marcocci C, Marino` M, Mourits MP, Nardi M, Orgiazzi J, Pinchera A, Pitz S, Prummel MF & Wiersinga WM. A questionnaire survey on the management of Graves’ orbitopathy in Europe. European Journal of Endocrinology 2006;155:207–211.
- Mourits MP, Koornneef L, Wiersinga WM, Prummel MF, Berghout A & van der Gaag R. Clinical criteria for the assessment of disease activity in Graves’ ophthalmopathy: a novel approach. British Journal of Ophthalmology, 1989;73:639–644.
- Mourits MP, Prummel MF, Wiersinga WM & Koornneef L. Clinical activity score as a guide in the management of patients with Graves’ ophthalmopathy. Clinical Endocrinology, 1997;479–14.
- The definition and classification of dry eye disease: report of the Definition and classification Subcommittee of the International Dry Eye Workshop. Ocul Surf 2007:5:88.
- Lamp MA. Report of the National Eye Institute/Industry workshop on Clinical Trials in Dry Eyes. CLAO J;1995;21:221–232.
- Nelson DJ, Havener VR, Cameron JD. Cellulose acetate impressions of the ocular surface: dry eye states. Arch Ophthalmol,1983;101:1869-1872.
- Brasil MV, Brasil OF, Vieira RP, et al. Tear film analysis and its relation with palpebral fissure height and exophthalmos in Graves’ ophthalmopathy. Arq Bras Of talmol 2005;68:615–618.
- Jae Ryun Kim et al, Risk Factors for Dry Eye in Thyroid- Associated Ophthalmopathy J Korean Ophthalmol Soc. 2011 Jul;52(7):771-776.
- Dilyara S. Ismail ova et al. Ocular Surface Changes in Thyroid Eye Disease, Orbit, 2013;32(2):87–90.
- Wei YH, Chen WL, Hu FR, Liao SL. In vivo confocal microscopy of bulbar conjunctiva in patients with Graves' ophthalmopathy. J Formos Med Assoc. 2015;114(10):965-72.
How to Cite This Article
Vancouver
Rizvi SAR, Rana V, Sheelu , Siddiqi S, Maheshwari V, Gupta Y. Dry eye evaluation in thyroid associated orbitopathy [Internet]. IP Int J Ocul Oncol Oculoplasty. 2016 [cited 2025 Oct 14];2(2):90-94. Available from: https://doi.org/
APA
Rizvi, S. A. R., Rana, V., Sheelu, , Siddiqi, S., Maheshwari, V., Gupta, Y. (2016). Dry eye evaluation in thyroid associated orbitopathy. IP Int J Ocul Oncol Oculoplasty, 2(2), 90-94. https://doi.org/
MLA
Rizvi, Syed Ali Raza, Rana, Vinod, Sheelu, , Siddiqi, Shafiq, Maheshwari, Veena, Gupta, Yogesh. "Dry eye evaluation in thyroid associated orbitopathy." IP Int J Ocul Oncol Oculoplasty, vol. 2, no. 2, 2016, pp. 90-94. https://doi.org/
Chicago
Rizvi, S. A. R., Rana, V., Sheelu, , Siddiqi, S., Maheshwari, V., Gupta, Y.. "Dry eye evaluation in thyroid associated orbitopathy." IP Int J Ocul Oncol Oculoplasty 2, no. 2 (2016): 90-94. https://doi.org/