Ocular Surface Changes in Thyroid Eye Disease

Ismailova, D S; Федоров, А. А.; Grusha, Y.O.

doi:10.3109/01676830.2013.764440

Cited by 54 publications

(41 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The lacrimal gland physiologically expresses the TSH receptor, which, in active GO, can bind with circulating anti-TSHR autoantibodies and contribute to lacrimal gland impairment [46]. This is an immune-mediated lacrimal gland dysfunction initially characterized by inflammation and followed by gland fibrosis and dropout, manifesting as a secondary Sjögren's syndrome in long-lasting disease [46,47,48,49,50]. Proteomics of tear fluids demonstrated an upregulation of inflammatory proteins and a downregulation of protective proteins in GO, with a significantly different panel compared to dry-eye patients and controls [51].…”

Section: Recommendationsmentioning

confidence: 99%

The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy

et al. 2016

View full text Add to dashboard Cite

Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient's quality of life. Local measures (artificial tears, ointments and dark glasses) and control of risk factors for progression (smoking and thyroid dysfunction) are recommended for all patients. In mild GO, a watchful strategy is usually sufficient, but a 6-month course of selenium supplementation is effective in improving mild manifestations and preventing progression to more severe forms. High-dose glucocorticoids (GCs), preferably via the intravenous route, are the first line of treatment for moderate-to-severe and active GO. The optimal cumulative dose appears to be 4.5-5 g of methylprednisolone, but higher doses (up to 8 g) can be used for more severe forms. Shared decision-making is recommended for selecting second-line treatments, including a second course of intravenous GCs, oral GCs combined with orbital radiotherapy or cyclosporine, rituximab or watchful waiting. Rehabilitative treatment (orbital decompression surgery, squint surgery or eyelid surgery) is needed in the majority of patients when GO has been conservatively managed and inactivated by immunosuppressive treatment.

show abstract

Section: Recommendationsmentioning

confidence: 99%

The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Similarly, Wei et al [61] performed histopathological analysis (in vivo confocal microscopy) of IC membranes from 15 TO subjects versus 15 controls, to investigate changes to the conjunctiva. As seen by Ismailova et al [60], Wei et al [61] noted reduced bulbar conjunctival goblet cell density (superior and temporal, p < 0.004 and p < 0.01, respectively), as well as significantly increased squamous metaplasia in the TO group (both superior and temporal, p < 0.001). Moreover, the latter study found significantly lower levels of superficial epithelial cell density in the superior bulbar conjunctiva, versus controls (p = 0.002).…”

Section: Thyroid Orbitopathymentioning

confidence: 70%

“…Moreover, the latter study found significantly lower levels of superficial epithelial cell density in the superior bulbar conjunctiva, versus controls (p = 0.002). Both studies appear to endorse the fact that IC can be used to confirm a clinical diagnosis of DED in patients with TO [60,61]. The question remains as to whether these findings are specific to TO and so this may be where the identification of other biomarkers of ocular surface inflammation, that are specific to the condition, comes into play.…”

Section: Thyroid Orbitopathymentioning

confidence: 87%

“…A review of the literature concerning TO, ocular surface inflammation/DED and IC yielded a number of studies, some of which will be discussed here. A study by Ismailova et al [60] assessed 92 eyes from 46 patients with TO in order to ascertain morphological changes to the ocular surface. Following ocular surface damage (DED) being identified in 56 eyes (via positive lissamine green staining), these eyes underwent conjunctival histological analysis.…”

Section: Thyroid Orbitopathymentioning

confidence: 99%

“…Using IC, the authors reported goblet cell loss, extreme desquamation of superficial cells and epithelial keratinization. This group concluded that, although the conjunctival histopathological changes were consistent with DED, they were not specific for TO [60]. Similarly, Wei et al [61] performed histopathological analysis (in vivo confocal microscopy) of IC membranes from 15 TO subjects versus 15 controls, to investigate changes to the conjunctiva.…”

Section: Thyroid Orbitopathymentioning

confidence: 99%

See 2 more Smart Citations

Biomarkers of Ocular Surface Disease Using Impression Cytology

Hagan

2017

Biomark. Med.

View full text Add to dashboard Cite

Impression cytology (IC) is a technique which permits the retrieval of the outermost layer of ocular surface cells via the use of various types of filters. It is a minimally invasive method of evaluating human conjunctival epithelial cell morphology in the diagnosis of dry eye disease, a common and distressing disorder associated with ageing, contact lens wear, autoimmune disorders and refractive (LASIK) surgery. IC may also be utilized in the diagnosis of other ocular diseases, such as keratoconus and thyroid orbitopathy. More recently, IC has been utilized for the subsequent investigation of gene and protein expression of conjunctival cells in order to identify novel diagnostic biomarkers and to further our understanding of the mechanisms underlying ocular surface disease. This review will therefore examine the literature concerning the role of IC in identifying cellular markers of eye disease, systemic diseases with ocular involvement and potential novel therapeutic targets. Impression cytology (IC) is a minimally invasive method of evaluating human ocular surface cells and is considered as the 'gold standard' technique for assessing cell morphology. Introduced by Thatcher et al. [1] and Egbert et al. [2], IC is an easy-to-use technique of directly retrieving (mainly conjunctival) cells, using various filter types which are gently applied to exposed (interpalpebral) conjunctival surfaces. The filters used include cellulose acetate [3], polycarbonate (Biopore, Millipore UK Ltd, Watford, UK) [4], nitrocellulose [5] or polyethersulfone (PES) [6] which are gently applied to exposed (interpalpebral) conjunctival surfaces. Recently, a more standardized tool for IC sampling has been introduced (Figures 1 & 2). The Eyeprim is a new single-use PES filter sampling medical device for retrieval of conjunctival cells (Opia Technologies, France) and a recent study by Lopez-Miguel et al. [7] performed an analysis of this tool versus the traditional IC method (PES). On a cohort of 20 healthy individuals, they extracted and compared RNA from both devices and found no significant differences in the mean yield (p ≥ 0.45), the total RNA amount (μg), or the amount normalized to membrane area [7]. Although an earlier study of the Eyeprim [8], suggested that it recovered more cells than traditional IC, Lopez-Miguel et al. [7] did not observe differences in the RNA collected between this device and PES.Historically, IC has been used to analyze pathological changes to conjunctival cells for indicators of squamous metaplasia in ocular surface disease (OSD) [9]. More recently, however, researchers have used IC to examine specific markers of inflammation, for example, HLA-DR, ICAM-1 and CD8 [10][11][12], and to examine novel biomarkers of dry eye disease (DED). The latter is performed in an attempt to understand the mechanisms underpinning DED pathophysiology and is now feasible, due to vast improvements in the assay sensitivities for gene and protein examination [13]. As a result, IC membranes can be subsequently analyzed using techniq...

show abstract

Different Phenotypes and Ocular Surface Changes in Thyroid-Associated Orbitopathy

Uddin,

Azzam

2024

Oculoplastic, Lacrimal and Orbital Surgery

View full text Add to dashboard Cite

Ocular Surface Changes in Thyroid Eye Disease

Cited by 54 publications

References 7 publications

The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy

The 2016 European Thyroid Association/European Group on Graves' Orbitopathy Guidelines for the Management of Graves' Orbitopathy

Biomarkers of Ocular Surface Disease Using Impression Cytology

Different Phenotypes and Ocular Surface Changes in Thyroid-Associated Orbitopathy

Contact Info

Product

Resources

About