Ocular surface evaluation in pediatric Hashimoto's thyroiditis without thyroid-associated ophthalmopathy

Area of Science:

• Ophthalmology
• Endocrinology
• Pediatrics

Background:

• Hashimoto's thyroiditis is an autoimmune disease affecting the thyroid gland.
• Ocular surface complications can occur in autoimmune conditions.
• The ocular surface status in children with Hashimoto's thyroiditis, particularly without thyroid-associated ophthalmopathy, requires further investigation.

Purpose of the Study:

• To evaluate ocular surface characteristics in pediatric patients diagnosed with Hashimoto's thyroiditis.
• To compare these findings with a control group of healthy children.
• To determine if subclinical ocular surface changes are present in children with Hashimoto's thyroiditis.

Main Methods:

• A comparative study involving 22 children with Hashimoto's thyroiditis and 20 healthy controls.
• Assessment included the Ocular Surface Disease Index questionnaire, tear film osmolarity, Schirmer test, tear film breakup time, meibography, and conjunctival brush cytology.
• Statistical analysis was performed to compare results between the two groups.

Main Results:

• Children with Hashimoto's thyroiditis exhibited significantly lower Schirmer test scores (p=0.001) and tear film breakup times (p=0.013) compared to controls.
• Meibomian gland area loss was significantly higher in the Hashimoto's thyroiditis group (25.01%) versus the control group (16.54%) (p=0.002).
• Conjunctival cytology revealed more inflammatory changes (grade 1 and 2) in children with Hashimoto's thyroiditis (p=0.001).

Conclusions:

• Pediatric patients with Hashimoto's thyroiditis demonstrate significant ocular surface abnormalities.
• These findings suggest a predisposition to dry eye disease in this population, even in the absence of overt thyroid-associated ophthalmopathy.
• Ocular surface evaluation should be considered in the comprehensive management of children with Hashimoto's thyroiditis.