Unilateral acute secondary angle-closure glaucoma in active thyroid eye disease

Abstract

Thyroid eye disease (TED) is the most common and disfiguring orbital disease in adults. This complex condition is characterized by autoimmune-mediated inflammation of the orbital soft tissues, extraocular muscles, and eyelids. Majority of those with TED have autoimmune hyperthyroidism (Graves disease), but rarely patients can have hypothyroidism or normal thyroid function. Association of TED with open-angle glaucoma has been reported widely, whereas its association with angle-closure glaucoma has been sparsely reported as case reports. We report two instances of secondary angle-closure glaucoma (SACG) in patients with active TED, with focus on clinical presentation, diagnostic challenges, and presumed mechanisms of angle closure.

Association between Thyroid Function and Ocular Parameters

“…The results of our study support those studies that did not observe a change in corneal thickness in hypothyroidism [ 7 , 17 , 20 , 25 ]. A patient with hyperthyroidism had a shallow anterior chamber depth [ 34 ], which was in accordance with our results, since a decrease in anterior chamber depth was observed in patients with hyperthyroidism. Additionally, Ozturk et al did not observe a change in anterior chamber depth in hypothyroidism [ 7 ], which conflicted with the results of our study, since we observed a decrease in anterior chamber depth in hypothyroidism.…”

“…Of the other ocular parameters analysed in our study, we found that only anterior chamber depth and IOL power have previously been associated with thyroid gland function. Anterior chamber depth was both altered [ 33 , 34 ] and normal [ 35 ] in patients with TED. Hypothyroidism did not affect anterior chamber parameters (anterior chamber volume, depth, and angle) [ 7 ].…”