Ocular morphology development and function in children with congenital hypothyroidism diagnosed by neonatal screening

Tropeano, Angelo; Roszkowska, Anna M.; Aversa, Tommaso; Corica, Domenico; Pepe, Giorgia; Aragona, Pasquale; Wasniewska, Malgorzata

doi:10.1007/s12020-020-02457-4

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…There was no statistically significant difference between the CH group and the healthy control group for any parameter, suggesting that corneal morphology was not influenced by eventual thyroid hormones alterations in CH patients. In this regard, Tropeano et al 33 reported that other ocular characteristics like ocular motility, axial length, lens transparency, and retinal morphology did not present statistically significant differences between patients affected by congenital hypothyroidism and healthy controls. This could be explained considering the prompt and adequate substitutive hormonal therapy and treatment compliance.…”

Section: Discussionmentioning

confidence: 94%

“…Congenital hypothyroidism affects nearly 1 in 2000 newborns and neonatal screening allows an early diagnosis in order to start immediate substitutive therapy. 32,33 The purpose of our study was to analyze the corneal and anterior chamber parameters in patients affected by congenital hypothyroidism in attempt to evidence eventual abnormalities related to the lower thyroid hormone availability during the fetal and early postnatal life. The 31 CH patients were diagnosed thanks to neonatal screening and treated promptly within 30 days.…”

Section: Discussionmentioning

confidence: 99%

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Is keratoconus associated to thyroid diseases? Assessment of the corneal parameters in patients with congenital hypothyroidism

Roszkowska

Alessandrello

Waśniewska

et al. 2021

European Journal of Ophthalmology

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Purpose: To investigate the association between keratoconus and congenital hypothyroidism (CH). Patients and methods: Patients were enrolled in this study and divided into two groups. The first group comprised 31 subjects (11M:20F) with the mean age of 15.2 ± 3.9 years. affected by CH, and the control group was composed by 19 healthy individuals (8M:11F) aged 14.3 ± 4.6 years. All patients underwent complete ophthalmologic examination with visual acuity assessment, refraction, slit lamp examination, and retinoscopy. Corneal parameters were measured using Scheimpflug camera (Pentacam® Oculus, Germany). The main outcome measures considered for evaluation were: average corneal curvature (K), central corneal thickness (CCT), anterior elevation and posterior elevation at the thinnest point, corneal volume (CV), anterior chamber depth (ACD), and anterior chamber volume (ACV). Additionally, data from Belin/Ambrosio Enhanced Ectasia Display (BAD) and the high order aberrations were evaluated. Kolmogorov-Smirnov test was used to verify the Gaussian distribution, the comparison between the controls and cases group was performed by Mann-Whitney nonparametric test. A p value less than 0.05 was considered to be statistically significant. The odds ratio was performed in order to quantify the relationship between the congenital hypothyroidism and abnormal values displayed on front BAD. Results: The significant difference in the refractive status between both groups was observed. As to examined corneal and anterior chamber parameters no statistical differences were detected. Conclusions: Congenital hypothyroidism diagnosed and treated since the early postnatal life doesn’t induce abnormalities of corneal parameters suggestive for keratoconus.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Is keratoconus associated to thyroid diseases? Assessment of the corneal parameters in patients with congenital hypothyroidism

Roszkowska

Alessandrello

Waśniewska

et al. 2021

European Journal of Ophthalmology

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“…The authors suggested that fasting ingestion of levothyroxine should be advised when a specific serum TSH goal is desired [ 17 ]. Specific serum TSH goal is usually desirable during initial 3–4 years of age to avoid any compromise with early brain growth and other developmental issues [ 6 , 19 , 20 ]. For this reason, we did not include children below 4 years of age.…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy of early morning versus bedtime administration of levothyroxine in children with hypothyroidism: a prospective, open label, randomized, case-control study

Navid¹,

Dayal²,

Kaur³

et al. 2021

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Introduction: Studies in adults with hypothyroidism suggest an equal efficacy of bedtime versus early morning intake of levothyroxine. There is limited data on timing of levothyroxine administration in children. Methods: Children with hypothyroidism on early morning levothyroxine, and clinically and biochemically euthyroid, were assigned to receive levothyroxine at bedtime (group A) or were continued on early morning levothyroxine intake (group B). Clinical, anthropometric and laboratory evaluation (thyroid and lipid profiles, liver enzymes and creatinine) was done at baseline, and at 3 and 6 months. Results: Eighty-four children, 42 in each group, completed the study. The clinical and anthropometric parameters remained similar in the two groups at baseline and at 3-and 6-month follow-up visits. There was no difference in the mean serum concentrations of triiodothyronine, thyroxine and thyrotropin at the 3 time-points in the study. In addition, mean serum aspartate transaminase, alanine transaminase, creatinine and parameters of lipid profiles remained similar in the two groups. The requirement of levothyroxine was similar at baseline (48.6 ±16.9 μg vs. 49.6 ±19.5 μg, p-value 0.80) and at the endpoint (48.3 ±17.2 μg vs. 51.9 ±18.0 μg, p-value 0.46) in both groups. At the study end, 25 (60%) patients in group A and 17 (40%) in group B preferred bedtime dosing of levothyroxine. Conclusions: We found an equal efficacy of bedtime intake compared to early morning intake of levothyroxine in maintaining an euthyroid state in children with hypothyroidism. Further studies are required to see if bedtime levothyroxine administration improves the quality of life of patients.

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“…THs are involved in the development of normal neuronal networks, and if CH is not treated it can lead to severe, permanent alterations in brain anatomy and function ( 5 ). It is important to consider that many complications, such as brain disorders and injuries and nerve growth retardation, may not be clinically recognizable in the first weeks of life leading to delay in the introduction of treatments that can prevent disabling and severe outcomes ( 4 , 6 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

An Overview on Different L-Thyroxine (l-T4) Formulations and Factors Potentially Influencing the Treatment of Congenital Hypothyroidism During the First 3 Years of Life

et al. 2022

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Congenital hypothyroidism (CH) is a relatively frequent congenital endocrine disorder, caused by defective production of thyroid hormones (THs) at birth. Because THs are essential for the development of normal neuronal networks, CH is also a common preventable cause of irreversible intellectual disability (ID) in children. Prolonged hypothyroidism, particularly during the THs-dependent processes of brain development in the first years of life, due to delays in diagnosis, inadequate timing and dosing of levothyroxine (l-thyroxine or l-T4), the non-compliance of families, incorrect follow-up and the interference of foods, drugs and medications affecting the absorption of l-T4, may be responsible for more severe ID. In this review we evaluate the main factors influencing levels of THs and the absorption of l-T4 in order to provide a practical guide, based on the existing literature, to allow optimal follow-up for these patients.

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Ocular morphology development and function in children with congenital hypothyroidism diagnosed by neonatal screening

Cited by 4 publications

References 20 publications

Is keratoconus associated to thyroid diseases? Assessment of the corneal parameters in patients with congenital hypothyroidism

Is keratoconus associated to thyroid diseases? Assessment of the corneal parameters in patients with congenital hypothyroidism

Comparative efficacy of early morning versus bedtime administration of levothyroxine in children with hypothyroidism: a prospective, open label, randomized, case-control study

An Overview on Different L-Thyroxine (l-T4) Formulations and Factors Potentially Influencing the Treatment of Congenital Hypothyroidism During the First 3 Years of Life

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