Abstract
Objective. The aim of the study was to assess visual acuity, refractive status, and eye proptosis in children and young adults with Graves' disease. Material and Methods. We have done investigations of visual acuity, refraction, and eye proptosis in 16 children, 14 teenagers, and 49 adults with Graves' disease at Eye Clinic of Lithuanian University of Health Sciences Medical Academy. Data were compared with 14 children, 14 teenagers, and 35 adults of similar age without the same diseases (control group). Results. In the present study we observed a significant decrease of visual acuity in teenagers (0.73 ± 0.18, P = 0.001) and adults (0.7 ± 0.16, P = 0.001) with Graves' disease. Myopia was ascertained more frequent in teenagers (42.8 percent) and adults (44.9 percent) with Graves' disease. In our study exophthalmometer values were higher in children (15.94 ± 1.98 mm, P = 0.003), teenagers (17.28 ± 2.99 mm, P = 0.01), and adults (18.05 ± 2.91 mm, P = 0.001) in comparison with the controls. Conclusions. The data we have found suggest that Graves' disease in children, teenagers, and adults has influence on vision acuity, refraction, and eye proptosis.
Highlights
IntroductionPatients with thyroid disease (thyrotoxicosis, diffuse, or nodular goiter) can manifest different eye lesions: eye proptosis, changes in vision, and refraction characterized by a multifactor mechanism of development
Patients with thyroid disease can manifest different eye lesions: eye proptosis, changes in vision, and refraction characterized by a multifactor mechanism of development
There was no significant difference between the children control and patients groups (Table 1)
Summary
Patients with thyroid disease (thyrotoxicosis, diffuse, or nodular goiter) can manifest different eye lesions: eye proptosis, changes in vision, and refraction characterized by a multifactor mechanism of development. Endocrine ophthalmopathy (Graves’ ophthalmopathy) presents as an autoimmune process which affects soft ocular tissue, eye muscles, cornea, and optic nerve [1]. These symptoms and signs typically peak at approximately 6 to 24 months following the onset of Graves’ disease and have a significant impact on visual function [2]. Inflammatory mediators released by lymphocytes in the orbit drive orbital fibroblasts to produce glycosaminoglycans. This causes interstitial edema and enlargement of extraocular muscles within the tight confines of the orbit, with secondary mechanical effects [3]. Proliferation of retrobulbar cells (fatty and connective tissue cells lacrimal gland cells) and their infiltration with lymphocytes, plasmic cells, macrophages, mucopolysaccharides and the excretion of various inflammatory factors as well as an increased extent of extraocular muscles have an influence on the development of exophthalmos [4]
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