COMPARISON OF TEAR FILM BREAKUP PATTERN IN ACTIVE AND INACTIVE THYROID EYE DISEASE PATIENTS
Abstract
Introduction: Thyroid Eye Disease (TED) is an autoimmune inflammatory disease of the orbit that affects orbital fat, extraocular muscles, periocular tissue and lacrimal glands. TED activity can be assessed with a Clinical Activity Score (CAS) to identify active or inactive TED conditions. Dry Eye Diseases (DED) is one of the manifestations in patients with TED with a prevalence that varies from 27%-96%. The Asia Dry Eye Society (ADES) 2017 proposed a new concept for DED diagnosis and therapy, namely Tear Film Oriented Diagnosis (TFOD) and Tear Film Oriented Diagnosis Therapy (TFOT) with Tear Film Breakup Pattern (TBUP) examination. TBUP examination help in determine specific management of DED. The aim of this study is to determine the differences in TBUP in TED patients based on active and inactive.
Methods: This is an analytical observational study with a cross-sectional design. The subjects were TED patients who came to the Cicendo Eye Hospital and met the inclusion criteria. The study was conducted at the National Eye Center of Cicendo Eye Hospital in April - June 2022. The data were analysed with the Chi-Square Test.
Result: This study was conducted on 23 patients or 46 eyes. This study found a statistically significant differences in TBUP features in active and inactive TED patients (p=0.0001). The most common features of TBUP was found in active TEDs was dimples (55%).
Conclusion: There are differences of TBUP features in active and inactive TED patient.
Full text article
References
American Academy of Ophthalmology. Section 8: External Disease and Cornea. in Basic and Clinical Science Cource 98–103 (2020).
PJ, D. Thyroid Eye Disease. in Ophthalmology 5th Edition (eds. O, Z., Yanoff, M. & Duker, J. S.) 1344–51 (Elsevier Health Science, 2019).
Park, J. & Baek, S. Dry eye syndrome in thyroid eye disease patients: The
role of increased incomplete blinking and Meibomian gland loss. Acta Ophthalmologica vol. 97 e800–e806 (2019).
Douglas, R. S. & A, M. Thyroid Eye Disease. (Springer Science, 2015).
Bartalena, L. et al. The 2021 EUGOGO Clinical Practice Guidelines for the Medical Management of Graves’ Orbitopathy. European Journal of Endocrinology 185, L13–L14 (2021).
Matheis, N. et al. Proteomics differentiate between thyroid-associated orbitopathy and dry eye syndrome. Investigative Ophthalmology and Visual Science 56, 2649–2656 (2015).
Tirakunwichcha, S., Lerdchanapornchai, V., Reinprayoon, U., Saonanon, P.
& Snabboon, T. Prevalence of dry eye disease in autoimmune thyroid disease
and the association of dry eye with clinical signs of thyroid associated ophthalmopathy: Observational, non-comparative, cross-sectional study. Asian Biomedicine 10, 133–138 (2016).
Selter, J. H., Gire, A. I. & Sikder, S. The relationship between Graves’ ophthalmopathy and dry eye syndrome. Clinical Ophthalmology 9, 57–62 (2014).
Kojima, T., Dogru, M., Kawashima, M., Nakamura, S. & Tsubota, K. 65
Advances in the diagnosis and treatment of dry eye. Progress in Retinal and Eye Research 78, 100842 (2020).
Yokoi, N. et al. Classification of Fluorescein Breakup Patterns: A Novel Method of Differential Diagnosis for Dry Eye. American Journal of Ophthalmology vol. 180 (Elsevier Inc., 2017).
Takahashi, Y., Lee, P. A. L., Vaidya, A., Kono, S. & Kakizaki, H. Tear film break-up patterns in thyroid eye disease. Scientific Reports 11, 1–8 (2021).
Xu N, Huang D, Yang, H., Lai, Z. & Quan, L. Ocular surface characteristics and impression cytology in patients with active versus inactive Thyroid Eye Disease. Eye Science 27, 64–8 (2012).
Achtsidis, V., Tentolouris, N., Theodoropoulou, S. & Panagiotidis, D. Dry Eye in Graves’ Ophthalmopathy: Correlation with Corneal Hypoesthesia. European Journal of Ophthalmology (2013).
Tu?an BS & Özkan B. Evaluation of Meibomian Gland Loss and Ocular Surface Changes in Patients with Mild and Moderate-to-Severe Graves’ Ophthalmopathy, Seminars in Ophthalmology, 2021:37:3, 271-276,
Kim JW, Young JW, Jin SY. Is modified clinical activity score an accurate indicator of diplopia progression in Graves’ orbitopathy patients?. Endocrine Journal.2016, 63 (12), 1133-1140
Allam, I. Y., Lazreg, S., Shaheen, M. S., Doheim, M. F. & Mohammed, M. A. Ocular surface changes in patients with thyroid eye disease: An observational clinical study. Clinical Ophthalmology 15, 2481–2488 (2021).
Villani, E. et al. Corneal involvement in Graves’ orbitopathy: an in vivo confocal study. Investigative ophthalmology & visual science 51, 4574–4578 (2010).
Lo, C., Yang, M. & Rootman, D. Natural history of inflammatory and noninflammatory dry eye in thyroid eye disease. Orbit (Amsterdam, Netherlands) 40, 389–393 (2021).
Huang D, Luo Q, Yang H, Mao Y. Changes of lacrimal gland and tear inflammatory cytokines in thyroid-associated ophthalmopathy. Invest Ophthalmol Vis Sci. 2014 Jul 3;55(8):4935-43
Authors
Copyright (c) 2024 Magdalena Purnama Soeprajogo, Shanti F Boesoirie, Antonia Kartika, Andika Prahasta, Angga Kartiwa, Angga Fajriansyah
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.