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Thyroid Eye Disease

Dry eye symptoms common in patients with euthyroid Graves’ ophthalmopathy

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Patients with Euthyroid Graves’ ophthalmopathy (EGO) experience more ocular surface complications and meibomian gland dropouts than healthy controls, according to a recent study. While nearly 60% of patients with EGO had dry eye symptoms, aqueous deficiency was not apparent. Further studies are needed to clarify the mechanism of dry eye in EGO, reported the researchers.

EGO is a subgroup of thyroid eye disease patients with distinct clinical presentations. The cross-sectional study, which evaluated the ocular surface and meibomian gland changes in patients with EGO, included 34 patients with EGO and 34 age-and sex- matched healthy controls. Outcome measures include anterior segment examination and keratographic and meibographic imaging.

The results demonstrated that between 34 patients with EGO and 34 controls, EGO was associated with a higher ocular surface disease index, higher severity of meibomian gland dropout, and higher percentage of partial blinking. The worse affected eyes of the EGO patients were associated with corneal staining, eyelid telangiectasia, eyelid thickening, eyelid irregularity, meibomian gland plugging, expressibility, and meibum quality. When the 2 eyes of the same patient with EGO were compared, the degree of meibomian gland dropout was higher among the worst affected eyes. Tear meniscus height, lipid layer thickness, and noninvasive break-up time were comparable between the 2 eyes of patients with EGO and between EGO patients and controls. Tear meniscus height was positively correlated with the degree of exophthalmos.

Reference
Lai KKH, Liao X, Aljufairi FMAA, et al. Ocular surface and meibomian gland evaluation in euthyroid Graves’ ophthalmopathy. Int Ophthalmol. 2024;44(1):124. doi:10.1007/s10792-024-02919-y

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