Effect of Radioactive Iodine Therapy on Lacrimal Gland Functions in Patients With Hyperthyroidism

Aydogan, Fusun; Tuzcu, Esra Ayhan; Aydogan, Akin; Akküçük, Seçkin; Çoşkun, Mesut; Üstün, İhsan; Gökçe, Cumali

doi:10.1097/rlu.0000000000000308

Cited by 7 publications

(7 citation statements)

References 9 publications

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“…The mean RAI dose in the hyperthyroid group was 603.1 MBq (ranging from 481 to 740 MBq); in the cancer group, it was 3700 MBq (mean and total). A low-iodine diet was prescribed 10 days before the therapy, and antithyroid medications were withdrawn 7 days before the therapy began 2,5 . RAI treatment was administered orally to all patients.…”

Section: Methodsmentioning

confidence: 99%

“…2 Although it is a safe treatment, 131 I may accumulate in extrathyroidal tissues such as gastric mucosa, intestine, choroid plexus, salivary glands, sweat glands, and lacrimal glands. [3][4][5] In particular, the literature has reported that the salivary gland is damaged and leads to dry mouth. [6][7][8] Since the lacrimal gland is a tissue with similar properties to the salivary gland, it has been investigated with the assumption that iodine may also affect tear secretion.…”

mentioning

confidence: 99%

“…Although studies are reporting that it causes dry eye by damaging the lacrimal gland, publications are reporting that it has no effect, and there are even publications reporting that it causes epiphora by obstructing the nasolacrimal duct. 5,[7][8][9][10][11][12] Studies on the lacrimal gland effect have been done with the Schirmer test and TBUT, but there are no studies evaluating tear osmolarity (TO). This study aimed to quantitatively evaluate the lacrimal glands before and after treatment with the Schirmer I test, TBUT test, and Tear Osmolarity test (TearLab) in patients receiving RAI treatment with hyperthyroidism and thyroid cancer.…”

mentioning

confidence: 99%

“…Compared with other techniques for treating hyperthyroidism and thyroid cancer, RAI therapies are safe, effective, simple, noninvasive, repeatable, and relatively inexpensive 2 . Although it is a safe treatment, 131 I may accumulate in extrathyroidal tissues such as gastric mucosa, intestine, choroid plexus, salivary glands, sweat glands, and lacrimal glands 3–5 . In particular, the literature has reported that the salivary gland is damaged and leads to dry mouth 6–8 .…”

mentioning

confidence: 99%

“…Since the lacrimal gland is a tissue with similar properties to the salivary gland, it has been investigated with the assumption that iodine may also affect tear secretion. Although studies are reporting that it causes dry eye by damaging the lacrimal gland, publications are reporting that it has no effect, and there are even publications reporting that it causes epiphora by obstructing the nasolacrimal duct 5,7–12 …”

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confidence: 99%

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Does Radioactive Iodine Treatment Damage the Lacrimal System?

Gürez,

Ergül

2024

Clin Nucl Med

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Purpose In this prospective study, we aimed to make a quantitative assessment of the lacrimal glands before and after radioactive iodine (RAI) treatment in patients with hyperthyroidism and thyroid cancer. Methods The study included 80 eyes of 40 patients. There were 25 patients in group 1 (hyperthyroid group) and 15 patients in group 2 (thyroid cancer group). Group 1 has received low dose (131I) and group 2 high dose (131I). Before, and at the first and sixth month after RAI treatment, all patients underwent ophthalmological examinations, Schirmer tests, TBUT tests, tear osmolarity (TO), and ocular surface examinations. Results The age and sex characteristics of both groups were similar. Although no significant change was observed in tear film tests before and after treatment in group 1, a significant decrease in Schirmer and TBUT values and a significant increase in TO were observed in group 2 in the first month after treatment. These values returned to normal in the sixth month. Although no Schirmer test was observed lower than 10 mm in any patient before RAI treatment, the Schirmer test was measured 5 to 10 mm in 4 (10%) patients in group 2 in the first month after treatment. Again, in these patients, TBUT was below 10 seconds and TO was greater than 308 mOsm/L. Conclusions In this study, although no change was observed in tear function tests in patients receiving low doses of RAI, a decrease in tear secretion and an increase in TO were detected in patients receiving high doses in the early period.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Does Radioactive Iodine Treatment Damage the Lacrimal System?

Gürez,

Ergül

2024

Clin Nucl Med

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Graves’ Disease: What Is the Role and Timing of Surgery?

Elfenbein

Sippel

2016

Controversies in Thyroid Surgery

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How Radioactive Iodine Treatment Affects the Retina

Gürez,

Özen,

Ekmekçioğlu

2023

World J Nucl Med

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Objective The aim of this study was to quantitatively assess the macular and retinal nerve fiber layer thicknesses in patients with hyperthyroidism and thyroid cancer undergoing radioactive iodine (RAI) therapy. Study Design This prospective study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the Bagcilar Training and Research Hospital Clinical Research Ethics Committee. Written informed consent was obtained from the patients following a detailed explanation of the study objectives and protocol. Patient selection was randomized. Patients scheduled for RAI treatment in the Nuclear Medicine Clinic were referred to the ophthalmology clinic, respectively. Patients without additional ocular pathology were included in the study. Methods All patients had received RAI therapy using Iodine-131 for hyperthyroidism or thyroid cancer. A complete ophthalmological examination and measurement of macular and retinal nerve fiber layer thickness using optical coherence tomography were performed on all patients before and at the first and sixth months and in first year after RAI treatment. The results were prospectively evaluated. Results The study included 80 eyes of 40 patients. The hyperthyroid group was group 1, and the thyroid cancer group was group 2. There were 25 patients in group 1 and 15 patients in group 2. The mean age was 43.76 ± 11.85 years (range: 22–65 years) in group 1 and 39.87 ± 9.13 years (range: 30–58 years) in group 2. There was no significant difference between the two groups regarding age and sex (p > 0.05). In both groups, no significant difference was found in the macular thickness and retinal nerve fiber layer thicknesses values obtained in both eyes before and after the RAI treatment. Conclusion As a result of our study, we observed that RAI intake did not harm the retinal layer.

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Effect of Radioactive Iodine Therapy on Lacrimal Gland Functions in Patients With Hyperthyroidism

Abstract: In our study, we concluded that the decrease in mucin and aqueous production occurs due to affected lacrimal glands by RAI therapy; however, this effect is not dose dependent.

Cited by 7 publications

References 9 publications

Does Radioactive Iodine Treatment Damage the Lacrimal System?

Does Radioactive Iodine Treatment Damage the Lacrimal System?

Graves’ Disease: What Is the Role and Timing of Surgery?

How Radioactive Iodine Treatment Affects the Retina

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