Thyroid-Associated Ophthalmopathy: Clinical Features, Pathogenesis, and Management

Yamada, Masayo; Li, Audrey Wu; Wall, Jack R.

doi:10.1080/10408360091174303

Cited by 55 publications

(42 citation statements)

References 153 publications

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“…It is possible that the improvement in the proptosis also had an effect on the amelioration of dry eye symptoms. It has been shown that the improvement of thyroid functions, which results in lowering of intraorbital glycosaminoglycan levels, may resolve the proptosis and palpebral angle widening (8). However, no statistically significant difference was found in the palpebral angle measurements between the three groups.…”

Section: Discussioncontrasting

confidence: 37%

“…The most common factors are T cell-dependent ocular surface inflammation, increased tear film evaporation and hyperosmolarity due to proptosis, especially in Graves' disease. Additionally, the effect of several inflammatory cytokines such as IL1-α, IL-4, and IGF-1 may play a role in this process (8). Recently, in addition to these factors, thyroid hormone receptors β-1 (Thrb-1), which are located on lacrimal glands, were found to be responsible for the development of dry eye (10).…”

Section: Introductionmentioning

confidence: 99%

“…Any defect in the lacrimal gland, eyelid, and the ocular surface may lead to this syndrome (6). Dry eye is also the most common finding of thyroid-associated ophthalmopathy (TAO) (7) in thyroid disorders such as Graves' disease and Hashimoto thyroiditis (8). TAO is defined as an autoimmune disease of the extraocular muscle tissue and the lacrimal glands, characterized by extraocular myopathy, optic neuropathy, and ocular surface inflammation (9).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Relationship Between Thyroid Functions and Dry Eye Symptoms in Patients with Hashimoto Thyroiditis

Yalin¹,

Cenik²,

Sayın³

et al. 2017

Turk J Endocrinol Metab

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E Ev va al lu ua at ti io on n o of f t th he e R Re el la at ti io on ns sh hi ip p B Be et tw we ee en n T Th hy yr ro oi id d F Fu un nc ct ti io on ns s a an nd d D Dr ry y E Ey ye e S Sy ym mp pt to om ms s i in n P Pa at ti ie en nt ts s w wi it th h H Ha as sh hi im mo ot to o T Th hy yr ro oi id di it ti is s H Ha as sh hi im mo ot to o T Ti ir ro oi id di it ti i T Ta an nı ıl lı ı H Ha as st ta al la ar rd da a K Ku ur ru u G Gö öz z S Se em mp pt to om ml la ar rı ın nı ın n T Ti ir ro oi id d F Fo on nk ks si iy yo on nl la ar rı ı i il le e O Ol la an n İ İl li iş şk ki is si in ni in n D De eğ ğe er rl le en nd di ir ri il lm me es si i Purpose: Dry eye is the most common symptom of thyroid-associated ophthalmopathy in Hashimoto thyroiditis. Ocular surface inam-mation, tear hyperosmolarity and overproduction of inammatory cytokines are responsible for the development of this process. In this study, we aimed to investigate the relationship between thyroid functions and dry eye symptoms in patients with Hashimoto thyroiditis. Materials and Methods:The patients, diagnosed with Hashimoto thyroiditis (n:125), were included in this monocenter cross-sectional study. The study population was divided into three groups: euthyroidism (Group-1, n:48), subclinical hypothyroidism (Group-2, n:38) and overt hypothyroidism (Group-3, n:39). The groups were compared based on the presence of dry eye syndrome, Schirmer tests, OSDI scores of patients with dry eye diagnosis and tear break-up time. The results were analyzed with ANOVA and Spearman's correlation test. Results:No signicant difference was found in the frequency of dry eye syndrome between the groups (p = 0.1). There was no difference in the Schirmer scores and tear break-up time measurements (p = 0.6 and 0.2). The severity of OSDI scores was signicantly milder in the patients with dry eye diagnosis, in the euthyroid group (p = 0.03). Serum fT3 levels positively correlated with tear break up time measurements (p = 0.004, r = 0.302) and negatively correlated with presence of dry eye syndrome (p = 0.03, r = -0.981). Discussion: Although dry eye symptoms tend to be milder in euthyroid patients, the frequency of dry eye syndrome is similar in patients with Hashimoto thyroiditis, independent of thyroid function status. Keywords: Dry eye, OSDI, Hashimoto thyroiditisAmaç: Hashimoto tiroiditi tanısı olan hastalarda tiroid fonksiyonlarının durumu ile kuru göz semptomlarının şiddeti arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Prospektif klinik çalışmaya 125 Hashimoto tiroiditi tanılı hasta dahil edilmiştir. Hastalar tiroid fonksiyon durumlarına göre ötiroid (Grup-1, n:48), subklinik hipotiroid (Grup-2, n:38) ve aşikar hipotiroid (Grup-3, n:39) olmak üzere üç gruba ayrılmıştır. Kuru göz tanısı, Schirmer testi, gözyaşı kırılma zamanı ve OSDI anket sonuçlarına göre konulmuştur. Kuru göz tanısı olan hastalarda semptomların şiddeti OSDI anketlerine gore belirlenerek tiroid fonksiyon durumu ile ilişkisi araştırılmıştır. Verilerin analizinde ...

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Section: Discussioncontrasting

confidence: 37%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Relationship Between Thyroid Functions and Dry Eye Symptoms in Patients with Hashimoto Thyroiditis

Yalin¹,

Cenik²,

Sayın³

et al. 2017

Turk J Endocrinol Metab

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“…Infiltration of activated T cells, B cells, and macrophages as well as the expansion of eye muscles and orbital fat tissues can be observed through histologic examinations of the retrobulbar tissues (Weetman et al, 1989). The course of GO is unpredictable and rapid deterioration can occur at any time (Bednarczuk et al, 2007;Yamada et al, 2000). The etiology of GD and GO may be multifactorial, involving complex interactions between genetic, environmental, endogenous and local factors (Farid and Balazs, 1998).…”

Section: Introductionmentioning

confidence: 99%

Association between interleukin 21 and Graves’ disease

Jia

Zhang²,

Gu³

et al. 2011

Genet. Mol. Res.

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ABSTRACT. Graves' disease (GD) is an organ-specific autoimmune thyroid disease; 25-50% of GD patients will develop Graves' ophthalmopathy (GO). The etiology of GD and GO may be multifactorial, but the immune response plays a central role. Many studies have reported that IL-21 has crucial roles in autoimmune diseases. We examined whether IL-21 is associated with the development of GD and GO. The serum concentration of IL-21 was tested in 40 primary GD patients, 42 treated GO patients and 24 healthy controls. Our data show that the serum level of IL-21 is associated with the development of GD. We also made an association study with the IL-21 gene polymorphisms rs4833837, rs907715 and rs13143866 in a comparison of 633 patients and 612 healthy controls from the Chinese population. This case-control association study demonstrated that rs907715 SNP is significantly associated with GD, while the rs13143866 A allele is significantly associated with GO. The haplotypes A-G-G and A-A-A were found ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 10 (4): 3338-3346 (2011) IL-21 and Graves' disease 3339 at higher and lower frequencies, respectively, in GD patients, suggesting a protective role for A-A-A. However, there were no significant differences in the frequencies of these haplotypes between the GO patients and the control group. We found no association between IL-21 gene polymorphisms and the age of GD onset. We conclude that IL-21 is associated with GD and GO.

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“…Many workers have investigated the possible existence of auto antigens that are expressed in both the thyroid and orbit [5,[13][14][15]. Such antigens include the TSHR [7,8,16], the 64-kDa protein, now identified as the Flavoprotein (Fp) sub-unit succinate dehydrogenase [17] or some other, as yet unidentified, thyroid and eye muscle shared cell membrane antigen.…”

Section: Introductionmentioning

confidence: 99%

Thyroid Peroxidase and Thyroglobulin Antibodies and Ophthalmopathy in Patients with Graves’ Disease, Hashimoto Thyroiditis and Transient Thyroiditis

Wall¹

2016

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Thyroid-Associated Ophthalmopathy: Clinical Features, Pathogenesis, and Management

Cited by 55 publications

References 153 publications

Evaluation of the Relationship Between Thyroid Functions and Dry Eye Symptoms in Patients with Hashimoto Thyroiditis

Evaluation of the Relationship Between Thyroid Functions and Dry Eye Symptoms in Patients with Hashimoto Thyroiditis

Association between interleukin 21 and Graves’ disease

Thyroid Peroxidase and Thyroglobulin Antibodies and Ophthalmopathy in Patients with Graves’ Disease, Hashimoto Thyroiditis and Transient Thyroiditis

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