Abstract
Background Nerve growth factor (NGF) plays an important role in the maintenance of the tear film stability.It is well known that the damage of ocular surface causes dry eye in the patients with thyroid-associated ophthalmopathy (TAO).However,if NGF is helpful for the stability of tear film is unclear.Objective This study was to investigate the relationship of NGF concentration in tear with tear film stability in TAO patient before and after glucocorticoid treatment.Methods Prospective observational cohort study was designed.This study was approved by the Ethic Committee of Binzhou Medical College,and written informed consent was obtained from each subject before entering this trial.Thirty-eight patients with active TAO and thirty age-and gender-matched controls were enrolled in the study.Prednisolone acetate tablets were administered in TAO patients for 4 weeks at a back-titration regimen.The tear fluid was collected and NGF level was detected by ELISA.Clinical activity score (CAS) was evaluated under the slit lamp lamp.Schirmer Ⅰ test (S Ⅰ t) was performed and breakup time of tear film (BUT) was obtained in controls and patients with active TAO before and 4 weeks after steroid treatment.Results Baseline NGF levels in tear was higher in the patients with active TAO than in the controls (U=-5.026,P＜0.01).NGF level decreased from 46.23 (42.34,51.42) ng/L to 27.45 (19.38,29.12) ng/L 4 weeks after steroid treatment (Z=-6.172,P＜0.05),and CASdecreased significantly from 6 (5,7) to4 (2,5) (Z=-2.496,P＜0.01).SⅠtvalue increased from 6 (4,11) mm to 11 (7,16) mm 4 weeks after steroid treatment (Z =-4.286,P＜0.05),and the BUT prolonged from 5 (3,9) seconds to 11 (6,14) seconds(Z=-3.160,P＜0.05).NGF levels in active TAO was significantly correlated with CAS (r=0.645,P＜0.01),S Ⅰ t value (r =-0.530,P＜0.01) and BUT (r =-0.430,P＜0.01).Conclusions Tear NGF may stabilized the tear film.The application of steroid anti-inflammation drug can reduce the tear NGF level,increase the tear secretion and improve the tear film stability in patients with active TAO. Key words: Nerve growth factor; Thyroid-associated ophthalmopathy; Tear; Ocular surface; Glucocorticoid
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