A clinical study of topical treatment for thyroid-associated ophthalmopathy with dry eye syndrome

Abstract

Introduction Clinically, thyroid-associated ophthalmopathy (TAO) patients were suffered from dry eye syndrome. Only a few relevant studies were about this topic. Our study was determined to provide high-level evidence for the treatment of TAO with dry eye syndrome. Purpose To compare the clinical effects of vitamin A palmitate eye gel and sodium hyaluronate eye drop forTAO patients with dry eye syndrome. Methods The study was conducted in the Ophthalmology Department of the Ninth People’s Hospital Affiliated with the Medical College of Shanghai Jiao Tong University from May to October 2020. A total of 80 mild or moderate-to-severe TAO patients with dry eye syndrome were randomly divided into two groups. The disease stages of all subjects were inactive. Patients in group A were treated with vitamin A palmitate eye gel three times/day for one month and sodium hyaluronate eye drop in group B. The index including break-up time (BUT) and Schirmer I test (ST), corneal fluorescence staining (FL), ocular surface disease index (OSDI), and adverse reactions were recorded by the same clinician at baseline and 1 month after treatment. The data were analyzed by SPSS 24.0. Results Finally, 65 subjects completed the treatment. The average age of the patients in Group A was 38.1 ± 11.4 years, and that in Group B was 37.26 ± 10.67 years. 82% of the subjects in group A were female and 74% in group B. There was no significant difference between the two groups at baseline, including the value of ST, BUT, OSDI, and FL grade. After the treatment, the effective rate was 91.2% in group A, of which the value of BUT and FL grade was significantly improved (P < 0.001). The effective rate in group B was 67.7%, of which the value of OSDI score and FL grade was significantly improved (P = 0.002). In addition, the BUT value of group A was significantly longer than that of group B (P = 0.009). Conclusion InTAO patients with dry eye syndrome, vitamin A palmitate gel and sodium hyaluronate eye drop improved the dry eye and promoted corneal epithelial repair. Vitamin A palmitate gel improves the stability of tear film, while sodium hyaluronate eye drop improves patients’ subjective discomfort.

Systematic review of ocular surface treatments in the setting of thyroid eye disease

“…Sun et al., compared the efficacy between vitamin A palmitate eye gel and 0.1% sodium hyaluronate eye drops in 80 patients (80 eyes) ( 14 ). Patients included in the study were diagnosed as having dry eye syndrome in the setting of moderate to severe thyroid associated ophthalmopathy at the inactive stage.…”

Aktuelle Therapieansätze der endokrinen Orbitopathie – sind die zielgerichteten Therapien die Zukunft?

“…Therapeutic approaches are similar to those of dry eye patients. Both topical CsA [165] as well as vitamin A-containing ointments are effective [166]. In dry eye EO patients, concomitant meibomian gland dysfunction (MDD) is often described, with a higher prevalence of obstructive MDD [167], which should then be treated accordingly.…”

“…Therapieansätze entsprechen denen der Patienten mit trockenen Augen. Sowohl topisches CSA ist wirksam [165] als auch Vitamin-A-haltige Salben [166]. Oft werden bei EO-Patienten mit trockenen Augen auch gleichzeitig eine Meibom-Drüsen-Dysfunktion (MDD) beschrieben mit höherer Prävalenz von obstruktiver MDD [167], die dann entsprechend behandelt werden sollte.…”

An ensemble deep learning diagnostic system for determining Clinical Activity Scores in thyroid-associated ophthalmopathy: integrating multi-view multimodal images from anterior segment slit-lamp photographs and facial images

“…The clinical manifestations of TAO are diverse and complex, including unilateral or bilateral eyelid retraction, exophthalmos, diplopia, restrictive strabismus, exposure keratopathy, and dysthyroid optic neuropathy, all of which significantly affect a patient’s quality of life Sun et al. ( 2 ).…”

“…It is the most common cause of adult orbital disease and also the most common extrathyroidal manifestation of diffuse toxic goiter (Graves' disease, GD) Bartalena et al (1). The clinical manifestations of TAO are diverse and complex, including unilateral or bilateral eyelid retraction, exophthalmos, diplopia, restrictive strabismus, exposure keratopathy, and dysthyroid optic neuropathy, all of which significantly affect a patient's quality of life Sun et al (2).…”