Local Ocular Surface Alterations in Children with Hashimoto's Thyroiditis

Area of Science:

• Ophthalmology
• Endocrinology
• Pediatrics

Background:

• Hashimoto's thyroiditis (HT) is an autoimmune disease primarily affecting the thyroid gland.
• Ocular surface changes can occur in autoimmune conditions, even without overt symptoms.
• Understanding these changes in children with HT is crucial for early detection and management.

Purpose of the Study:

• To assess ocular surface characteristics in children diagnosed with Hashimoto's thyroiditis.
• To compare tear film stability and conjunctival health between children with HT and healthy controls.
• To investigate the relationship between ocular surface parameters and the duration of HT.

Main Methods:

• A comparative study involving 51 children with HT and 53 age-matched controls.
• Ocular surface evaluation using Schirmer's test for tear production and tear break-up time (TBUT) for tear film stability.
• Conjunctival impression cytology (CIC) with Nelson grading to assess goblet cell density (GCD) and conjunctival cell changes.

Main Results:

• Children with HT exhibited significantly lower Schirmer's test values and TBUT compared to controls (p < .05).
• While overall CIC grading was similar (p = .841), goblet cell density (GCD) was significantly reduced in the HT group (p = .001).
• Schirmer's test results correlated negatively with the duration of Hashimoto's thyroiditis (p = .025, r = -0.311).

Conclusions:

• Hashimoto's thyroiditis can lead to subclinical ocular surface abnormalities, particularly reduced tear production and stability, even in asymptomatic children.
• Conjunctival impression cytology reveals a significant decrease in goblet cell density in children with HT, indicating potential inflammatory or autoimmune effects on the ocular surface.
• These findings highlight the importance of routine ocular surface screening in pediatric patients with Hashimoto's thyroiditis.