Abstract
Purpose. To evaluate the tear function tests in patients with Hashimoto's thyroiditis and to compare the results with healthy subjects. Methods. A hundred and ten patients with Hashimoto's thyroiditis and 100 healthy subjects were included in this study. The presence of thyroid-associated ophthalmopathy and tear function tests were evaluated clinically. The results were first compared between the patients and the control groups and then compared between patients with NOSPECS and patients without NOSPECS. Logistic regression analyses of the risk factors for dry eye including sex, gender, free plasma thyroxine, proptosis, upper eyelid margin-reflex distance, and duration of the disease were also evaluated. Results. The mean ocular surface disease index score was significantly higher and mean Schirmer and mean tear break-up time scores were significantly lower in patients compared to control subjects. Mean Schirmer and tear break-up time scores were found to be significantly lower in patients with NOSPECS when compared to the patients without NOSPECS. Both proptosis and free plasma thyroxine levels were significantly associated with dry eye. Conclusions. Patients with Hashimoto's thyroiditis tend to develop dry eye more common than healthy subjects. Proptosis and lower free plasma thyroxine levels were found to be risk factors for the presence of dry eye.
Highlights
Thyroid-associated ophthalmopathy (TAO) is an autoimmune disorder of the extraocular muscles and surrounding orbital connective tissue including lacrimal gland which is generally associated with Graves’ disease (GD) and rarely accompanies Hashimoto’s thyroiditis [1]
OSDI: ocular surface disease index; TBUT: tear break-up time. It has been demonstrated in this study that dry eye was found to be more common in patients with Hashimoto’s thyroiditis than control subjects and both proptosis and deficiency of fT4 were found as risk factors for the presence of dry eye in logistic regression analyses
Numerous studies have investigated the pathogenesis of dry eye associated with TAO
Summary
Thyroid-associated ophthalmopathy (TAO) is an autoimmune disorder of the extraocular muscles and surrounding orbital connective tissue including lacrimal gland which is generally associated with Graves’ disease (GD) and rarely accompanies Hashimoto’s thyroiditis [1]. The characteristic clinical findings of the TAO include proptosis due to an increase in the retroorbital soft tissue, lid retraction, restrictive extraocular myopathy, optic neuropathy, and inflammatory ocular surface disorders [2]. Reduced thyroid hormone levels were found to modulate the expression of Thrb in lacrimal gland, causing a decrease in tear production and subsequent dry eye in experimental studies [7]. That is why in the recent study we aimed to evaluate the presence of dry eye in Hashimoto’s disease and to compare with control subjects
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