Prevalence of dry eye disease in autoimmune thyroid disease and the association of dry eye with clinical signs of thyroid associated ophthalmopathy: observational, noncomparative, cross-sectional study
, , , and | Jan 31, 2017
About this article
Article Category: Brief communication (Original)
Published Online: Jan 31, 2017
Page range: 133 - 138
DOI: https://doi.org/10.5372/1905-7415.1002.474
Keywords
© 2016 Suppapong Tirakunwichcha, Vipavee Lerdchanapornchai, Usanee Reinprayoon, Preamjit Saonanon, Thiti Snabboon
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Multiple logistic regression; association of superior staining with thyroid eye signs in autoimmune thyroid disease (thyroid associated ophthalmopathy) (adjusted by proptosis, eyelid retraction, lagophthalmos, eyelid swelling, eyelid injection, MGD)
| Thyroid eye signs | Odds ratio | 95% Confidence interval | ||
|---|---|---|---|---|
| Lower | Upper | |||
| Proptosis | 0.04 | 4.5 | 1.1 | 17.9 |
| Eyelid retraction | 0.13 | 2.9 | 0.7 | 11.3 |
| Lagophthalmos | 0.90 | 1.1 | 0.2 | 6.4 |
| Eyelid swelling | 0.96 | 1.0 | 0.2 | 4.8 |
| Eyelid injection | >0.99 | 0 | 0 | |
| Meibomian gland dysfunction | 0.52 | 0.6 | 0.1 | 3.0 |
Association of dry eye with severity of thyroid associated ophthalmopathy
| Severity of TAO | ||||
|---|---|---|---|---|
| Mild | Mod-severe | |||
| OSDI | ≤20% | 43 (77%) | 8 (57%) | 0.18 |
| > 20% | 13 (23%) | 6 (43%) | ||
| TBUT | ≥10 | 1 (0.9%) | 3 (10%) | 0.03 |
| < 10 | 114 (99%) | 26 (90%) | ||
| Ocular surface staining | A | 13 (11%) | 6 (21%) | 0.22 |
| (Oxford scheme) | B-E | 102 (89%) | 23 (79%) | |
| Schirmer test | ≥5 | 87 (76) | 27 (93%) | 0.07 |
| < 5 | 28 (24%) | 2 (7%) | ||
Multiple logistic regression; association of dry eye with autoimmune thyroid disease (adjusted by proptosis, eyelid retraction, lagophthalmos and eyelid injection, MGD)
| Odds ratio | 95% Confidence interval | ||||
|---|---|---|---|---|---|
| Lower | Upper | ||||
| Ocular surface staining | Lagophthalmos | 0.03 | 5.8 | 1.2 | 27.7 |
| Meibomian gland dysfunction | 0.004 | 3.0 | 1.4 | 6.3 | |
| Schirmer test | Proptosis | 0.03 | 9.3 | 1.2 | 70.6 |
Univariate analysis, association of the thyroid eye signs with various dry eye criteria
| Eye signs | OSDI in AITD | Tear break-up time in AITD | Schirmer test in AITD | Ocular surface staining in AITD | Superior staining only in TAO | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Frequency | Frequency | Frequency | Frequency | Frequency | ||||||
| (%) | (%) | (%) | (%) | (%) | ||||||
| Proptosis | 6 (35%) | 0.55 | 32 (91%) | 0.18 | 1 (3%) | 0.02 | 25 (71%) | 0.83 | 7 (20%) | 0.01 |
| Eyelid swelling | 7 (32%) | 0.77 | 41 (98%) | 0.69 | 8 (19%) | >0.9 | 33 (79%) | 0.16 | 4 (10%) | 0.75 |
| Eyelid injection | 1 (100%) | 0.27 | 2 (100%) | >0.9 | 0 (0) | >0.9 | 2 (100%) | >0.9 | 0 (0) | >0.9 |
| Ptosis | 9 (33%) | 0.55 | 56 (95%) | 0.71 | 11 (19%) | >0.9 | 41 (70%) | 0.97 | 1 (2%) | 0.02 |
| Eyelid retraction | 6 (38%) | 0.36 | 33 (94%) | 0.65 | 2 (6%) | 0.06 | 23 (66%) | 0.85 | 6 (17%) | 0.08 |
| Lagophthalmos | 4 (50%) | 0.21 | 16 (84%) | 0.04 | 1 (5%) | 0.21 | 17 (90%) | 0.07 | 2 (11%) | 0.67 |
| Conjunctival injection | 0 (0) | 0.32 | 8 (80%) | 0.06 | 0 (0) | 0.21 | 7 (70%) | >0.9 | 6 (60%) | <0.001 |
| Conjunctival swelling | 1 (100%) | 0.27 | 3 (100%) | 1.00 | 0 (0) | >0.9 | 3 (100%) | 0.55 | 1 (33%) | 0.25 |
| Strabismus | 5 (71%) | 0.02 | 13 (93%) | 0.48 | 2 (14%) | >0.9 | 11 (79%) | 0.55 | 0 (0) | 0.36 |
Prevalence of dry eye in AITD patients
| Criteria | AITD patients (%) | 95% CI (%) of prevalence | All AITD patients presented with (%) | Difference in prevalence | ||
|---|---|---|---|---|---|---|
| Lower | Upper | Clinical TAO | No TAO | |||
| Ocular Surface Disease Index | 25 (27%) | 16 | 34 | 18 (30%) | 7 (23%) | 7% |
| Tear break-up time | 176 (96%) | 93 | 99 | 114(93%) | 62 (100%) | 7% |
| Ocular surface staining | 126 (69%) | 62 | 75.2 | 87 (71%) | 39 (63%) | 8% |
| Schirmer test | 33 (18%) | 12 | 23.4 | 19 (16%) | 14 (23%) | 7% |