Ocular surface changes in Graves’ ophthalmopathy

Sun, Rou; Zhou, Huifang; Fan, Xianqun

doi:10.18240/ijo.2021.04.20

Cited by 17 publications

(16 citation statements)

References 51 publications

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“…Hence, in recent years, the proteomic analysis of tear fluids from patients with TAO has been undertaken to better determine disease activity and to stratify patients accordingly, because the high concentration of proteins in tear fluid makes it an important source for studying potential protein biomarkers for GO [ 13 , 33 , 34 ]. Many studies have found several differences in the amount of proteins in active GO, inactive GO, and healthy controls, so we focused on the most recent findings [ 7 ].…”

Section: Markers In the Tears Of Patients With Graves’ Orbitopathymentioning

confidence: 99%

“…In response to the activation of these receptors by autoantigens, fibroblasts may modulate immune responses via the production of cytokines and extracellular matrix/hyaluronan and elicit an inflammatory reaction in the orbit. The production of glycosaminoglycans (GAGs) by orbital fibroblasts and the hyperplasia of adipose tissue contribute to the development of ocular symptoms such as enlarged extraocular muscles and increased fatty and connective tissue, resulting in protruding eyes, double vision, and in severe cases, visual field loss or even loss of vision [ 1 , 4 , 6 , 7 , 8 , 9 ]. The symptoms of GO are primarily due to inflammation, and the severity of GO is categorized as mild, moderate, and severe (including sight-threatening) [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, numerous biomarker candidates have been identified to play a role in GO; however, little is known about the function of most tear components [ 13 , 14 ]. In this context, many studies have quantified the amount of proteins and cytokines in tears and have found several differences in active GO, inactive GO, and healthy controls [ 7 ]; in this review, we focus on the most recent finding. This literature aimed to answer the following question: What is the role of tear fluid in the diagnosis of TAO?…”

Section: Introductionmentioning

confidence: 99%

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Tears as a Source of Biomarkers in the Diagnosis of Graves’ Orbitopathy

et al. 2022

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Thyroid eye disease (TED) is a poorly understood autoimmune manifestation of thyroid diseases most commonly associated with Graves’ disease. Due to a lack of specific biomarkers and uncertain signs and symptoms, Graves’ orbitopathy (GO) is challenging to diagnose early and treat effectively. Nowadays, there is great interest in searching for precise molecular biomarkers for early detection, disease monitoring, and clinical management. Researchers are keen to identify novel methods to predict and diagnose diseases and to monitor patient therapeutic response. Tears, due to their direct contact with the eye and the fact that lacrimal glands can also be affected by the disease, could give new insights into the mechanisms taking place in thyroid-associated orbitopathy (TAO) and reveal potential promising biomarkers. Tear fluid offers the possibility of the non-invasive acquisition of a sample with a high protein content, thereby attracting continuously growing interest in the discovery of novel biomarkers. This article provides an up-to-date overview of the various putative tear-fluid biomarkers that have been identified. In this review, we present the potential use of tears as a diagnostic fluid and tool to investigate the mechanism of ocular diseases and discuss the future research directions in this area.

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Section: Markers In the Tears Of Patients With Graves’ Orbitopathymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tears as a Source of Biomarkers in the Diagnosis of Graves’ Orbitopathy

et al. 2022

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“…In GO patients, the evaporation of tears may be caused by long-term ocular exposure because of eyelid retraction and proptosis ( 5 ). Studies have shown that lacrimal glands in GO patients are involved in autoimmune responses, leading to changes in the composition of tears ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Tear-derived exosomal biomarkers of Graves’ ophthalmopathy

et al. 2022

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Graves’ ophthalmopathy (GO), the most frequent extrathyroidal manifestation of Graves’ disease (GD), can lead to a significant decline in the quality of life in patients. Exosomes, which contain proteins, lipids and DNA, play important roles in the pathological processes of various diseases. However, their roles in Graves’ ophthalmopathy are still unclear. We aimed to isolate exosomes and analyze the different exosomal proteins. Tear fluids were collected from twenty-four GO patients, twenty-four GD patients and sixteen control subjects. The numbers of tear exosomes were assayed using nanoparticle tracking analysis. A Luminex 200 kit and ELISA kit were used to confirm the different cytokine concentrations in serum. Extraocular muscle from GO patients and controls was extracted, and western blotting was used to assay the levels of Caspase-3 and complement C4A. Our study demonstrated that the number of tear exosomes differ from GD patients and control. The expression levels of cytokines, including IL-1 and IL-18, were significantly increased in the tear exosomes and serum from GO patients compared with GD patients and controls. The levels of the exosomal proteins Caspase-3, complement C4A and APOA-IV were significantly increased in GO patients compared to GD patients and controls. Orbital fibroblasts from GO patients showed significantly higher levels of Caspase-3 and complement C4A than those from controls. The levels of serum APOA-IV in GO patients were significantly higher than those in GD patients and controls. Specific proteins showed elevated expression in tear exosomes from GO patients, indicating that they may play important roles in GO pathogenesis.

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“…Dry eye is one of the most common symptoms in TAO patients (Sun et al, 2021) [ 5 ]. A total of 65–85% of TAO patients are found to have complaints of dry eye symptoms (Selter et al, 2015) [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Improvement of Ocular Surface Disease by Lateral Tarsoconjunctival Flap in Thyroid-Associated Orbitopathy Patients with Lid Retraction

Hsu

Hsieh

Chang

et al. 2022

JPM

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There is a high incidence of ocular surface disease (OSD) in thyroid-associated orbitopathy (TAO) patients as a result of incomplete eyelid closure and chronic inflammatory eyelid status. This study was performed to evaluate the efficacy of a lateral tarsoconjunctival flap (LTF) in improving OSD in TAO patients from the perspective of correcting eyelid closures. As a study design, TAO patients were enrolled in this study to evaluate OSD perioperatively before they were scheduled for LTF surgery. Additional lid surgery was also recorded. The outcome was evaluated with perioperative OSD measurements and tear inflammatory mediators at baseline and one month and three months postoperatively. As a result, 42 patients (5 male, 37 female) underwent LTF surgery, and 13 patients received medial pretarsal support with collagen grafts. Eleven patients underwent blepharotomy, and 6 patients received Botox injections for upper lid retraction. The mean age of the participants was 46.4 years old, and the mean follow-up period was 10.6 months. Their clinical activity score (CAS) at the time of the operation was 2.1. Dry eye parameters, such as ocular surface disease index, tear breakup time, Schirmer’s I test score, and meibomian gland dropout were all significantly improved 3 months postoperatively. Tear osmolarity and inflammatory mediators in tear fluid, such as IL-6, IL-8, IL-18 and MCP-1, were also significantly improved after the procedures. After the surgery, all complications were mild and temporary. As a conclusion, LTF could provide TAO patients with both lid retraction correction and improvement of ocular surface disorders. Dry eye parameters significantly improved 3 months postoperatively. This method can serve as an alternative treatment option for lid correction in TAO patients.

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Ocular surface changes in Graves’ ophthalmopathy

Cited by 17 publications

References 51 publications

Tears as a Source of Biomarkers in the Diagnosis of Graves’ Orbitopathy

Tears as a Source of Biomarkers in the Diagnosis of Graves’ Orbitopathy

Tear-derived exosomal biomarkers of Graves’ ophthalmopathy

Improvement of Ocular Surface Disease by Lateral Tarsoconjunctival Flap in Thyroid-Associated Orbitopathy Patients with Lid Retraction

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