The ocular surface in thyroid diseases

Abstract

New horizons can be displayed on the basis of these new findings, in particular, as referred earlier, Graves' ophthalmopathy diagnosis. A detailed slit-lamp examination and a careful medical history by validated questionnaires in patients with ocular surface discomfort symptoms are now recommended to investigate early manifestations of an underlying thyroid dysfunction. Ocular surface signs should also be included in professional guidelines. Autoantibody assays in tears and proteomic analysis of tear protein expression could be important further steps in early diagnosis and posttherapy control of thyroid dysfunction.

Inflammatory cytokine profiles in the tears of thyroid-associated ophthalmopathy

“…The latest research indicated that inflammation plays a key role in ocular surface damage in TAO [15][16][17][18]. Gupta [18] suggested that TAO was a potential cause of inflammatory ocular surface disease with dry eye symptomatology based on a retrospective observational case study.…”

Graves' Orbitopathy Results in Profound Changes in Tear Composition: A Study of Plasminogen Activator Inhibitor-1 and Seven Cytokines

“…Reports have been published on the early conjunctival involvement in GD, suggesting that ocular surface impairment in GO is not only a consequence of mechanical events, but that ocular surface tissues are direct targets for autoantibodies in GD (45). Conjunctival and episcleral inflammation can occur before the classic signs of orbitopathy, and the pathogenesis is assumed to be similar to that involved in the extraocular muscle inflammation and lymphocytic infiltration in GO (46).…”

Prevalence of dry eye disease in autoimmune thyroid disease and the association of dry eye with clinical signs of thyroid associated ophthalmopathy: observational, noncomparative, cross-sectional study

“…The presence of autoantigens in the thyroid gland and extrathyroidal sites induces autoantibodies that assault the thyroid gland, lacrimal glands, and orbital fibroblasts, resulting in thyroid ophthalmopathy. Common findings are ocular surface disease, proptosis, lagophthalmos, eyelid retraction, restrictive strabismus, and compressive optic neuropathy [2][3][4]. Ocular discomfort results mainly from dry eye disease [3][4][5].…”

“…Common findings are ocular surface disease, proptosis, lagophthalmos, eyelid retraction, restrictive strabismus, and compressive optic neuropathy [2][3][4]. Ocular discomfort results mainly from dry eye disease [3][4][5]. A report of the Epidemiology Subcommittee of the International Dry Eye Workshop (2007) reported dry eye as a multifactorial disease and risk factors were demonstrated [6,7].…”