Ocular Surface Changes in Hashimoto's Thyroiditis Without Thyroid Ophthalmopathy

Area of Science:

• Ophthalmology
• Endocrinology
• Autoimmune Diseases

Background:

• Hashimoto's thyroiditis is an autoimmune disease affecting the thyroid gland.
• Ocular surface complications, including dry eye syndrome, can occur in patients with Hashimoto's thyroiditis.
• The relationship between Hashimoto's thyroiditis, dry eye syndrome, and meibomian gland dysfunction (MGD) requires further elucidation, especially in the absence of overt thyroid ophthalmopathy.

Purpose of the Study:

• To evaluate ocular surface changes in patients with Hashimoto's thyroiditis without thyroid ophthalmopathy.
• To investigate the association between dry eye syndrome and meibomian gland dysfunction (MGD) in Hashimoto's thyroiditis patients.
• To identify specific ocular surface parameters affected by Hashimoto's thyroiditis.

Main Methods:

• A prospective study involving 105 patients with Hashimoto's thyroiditis and 105 matched controls.
• Administration of the Ocular Surface Disease Index (OSDI) questionnaire.
• Comprehensive ocular surface evaluation including tear-film breakup time (TBUT), Schirmer 1 test, corneal staining, and meibomian gland assessment (expression, meibography).

Main Results:

• Patients with Hashimoto's thyroiditis exhibited significantly reduced TBUT, Schirmer 1 scores, and meibomian gland expression.
• Increased OSDI scores, corneal staining, eyelid abnormalities, and meibomian gland loss were observed in Hashimoto's thyroiditis patients.
• OSDI scores correlated positively with eyelid abnormalities and meibomian gland loss, and negatively with meibomian gland expression. Duration of Hashimoto's thyroiditis correlated positively with MGD.

Conclusions:

• Dry eye syndrome and ocular discomfort are significantly more prevalent in Hashimoto's thyroiditis patients, irrespective of thyroid ophthalmopathy.
• Meibomian gland dysfunction (MGD) is a likely cause of dry eye syndrome in Hashimoto's thyroiditis.
• The duration of Hashimoto's thyroiditis is associated with the severity of MGD.