Endocrine Abstracts

Aim: Dry eye syndrome(DES) is a common finding in patients with thyroid orbitopathy. There are few studies on DES in patients with papillary thyroid cancer (PTC). Retinal pathology may develop in case of vitamin E deficiency, which has antioxidant, anti-inflammatory and anti-apoptotic properties.

Materials and Methods: In our study, 29 patients who received radioactive iodine (RAI) treatment (Group 1) and 22 patients who did not receive RAI treatment (Group 2) with a diagnosis of PTC were included. 26 healthy individuals without PTC were determined as the control group (Group 3). Exclusion criteria were diabetes mellitus, rheumatologic diseases, keratoconus, glaucoma, history of contact lens use, previous eye surgery. Ocular surface disease index, meibomian gland secretion quality, lid margin score, noninvasive tear breakup time were evauated with sirius device and meibomagraphy in all patients. Thyrotropin (TSH), free thyroxine, free triiodothyronine, and vitamin E levels were measured.

Results: TSH levels were significantly lower in Group 1 and 2 compared to Group 3 (P<0.001, P<0.001, respectively). There was no significant difference between the groups in terms of vitamin E levels (P=0.599). The proportion of those with normal noninvasive tear breakup time (>17) was similar in Group 1, Group 2 and Group 3 (30.8%, 27.3%, and 44.6%, respectively, P=0.145). The proportion of those with an upper lid margin score of ≥1 was significantly higher in Group 1 and Group 2 than in the control group (64.9%, 56.8% and 17.9%; respectively, P=0.025). Lower meibomian gland expressivity was >1 in 34.5% of the patients in Group 1, 22.7% in Group 2, and 7.1% in Group 3 (P=0.002). The proportion of patients with lower meibomiagraphy values of ≥1 was significantly higher in Group 1 and Group 2 compared to the control group (61.1%, 52.5%, and 29.5%, respectively, P=0.007). There was no significant difference between the groups in terms of lower lid margin score, Oxford values, upper meibomian gland expressibility, and upper meibomiagraphy grades (P=0.485, P=0.064, P=0.256 and P=0.069, respectively). OSDI (survey questioning eye-related irritation symptoms) values were 6.25 in Group 1 and 8.12 in Group 2 and were significantly higher than the control group (2.27) (P=0.034).

Conclusion: Meibomian gland dysfunction is observed in patients with PTC who received and did not receive RAI. This may be related to TSH suppression. It is important to question these patients for a dry eye because it might affect their daily living activities.