Risk factors for structural changes in meibomian gland in thyroid eye disease

Minjae Kim, Sungwon Yang, Jinhwan Park, Hwa Lee, Se Hyun Baek

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate the effect of clinical activity score (CAS) and thyroid stimulating hormone receptor autoantibody (TSHR autoantibody) on structural changes in Meibomian gland in patients with thyroid eye disease (TED). Methods: From March 2015 to February 2016, retrospective and cross-sectional studies were performed on patients diagnosed with TED. We investigated thyroid function, TSHR autoantibody (thyrotopin-binding inhibitor immunoglobulin [TBII] assay) status, duration of TED, CAS, and analyzed the Meibomian gland structure using a Lipiview inferometer® (TearScience Inc., Morrisville, NC, USA). We evaluated the degree of meibum expression (ME) and the tear film breakdown time by slit lamp microscopy. Results: A total of 37 patients (13 males and 24 females) with TED were included in the study, and the mean age was 43.8 ± 13.3 years. At the time of the study, 24 patients (64.9%) had hyperthyroidism, five patients (13.5%) had hypothyroidism, and eight patients (21.6%) had normal functioning. The mean CAS was 1.86 ± 1.74 (0-7), nine patients (24.3%) were in the active group with ≥3 points of CAS, and 28 patients (75.7%) were in the inactive group with <3 points of CAS. The meiboscore was 1.05 ± 0.82 in the upper eyelid, and 0.76 ± 0.76 in the lower eyelid, with a significantly higher upper eyelid (p = 0.001). The mean value of the TBII was 6.11 ± 11.35 IU/L. Sixteen patients (43.2%) had TBII above the normal 1.5 value, and 21 patients (56.8%) had a normal TBII. The meiboscore of the upper eyelid was significantly higher when the TBII was higher than normal (p = 0.045). CAS (r = 0.356, p = 0.030), ME (r = 0.379, p = 0.021), and TBII (r = 0.334, p = 0.044) were significantly associated with the meiboscore in the upper eyelid. Using multiple regression analyses, CAS (p = 0.010) and TBII (p = 0.011) were factors affecting the upper eyelid meiboscore, and CAS (p = 0.015) and TBII (p = 0.038) were factors affecting the lower eyelid meiboscore. Conclusions: The structural loss of Meibomian glands in patients with TED was greater in the upper eyelid than lower eyelid, and CAS and TSHR autoantibody had an effect on the structural loss of the Meibomian gland.

Original languageEnglish
Pages (from-to)599-605
Number of pages7
JournalJournal of Korean Ophthalmological Society
Volume59
Issue number7
DOIs
Publication statusPublished - 2018 Jul 1

Fingerprint

Meibomian Glands
Eye Diseases
Thyroid Diseases
Eyelids
Immunoglobulins
Thyrotropin Receptors
Autoantibodies
Time and Motion Studies
Hyperthyroidism
Hypothyroidism
Tears
Thyroid Gland
Reference Values

Keywords

  • Clinical activity score
  • Meibomian gland dysfunction
  • Meiboscore
  • Thyroid eye disease
  • Thyroid stimulating hormone receptor autoantibody

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Risk factors for structural changes in meibomian gland in thyroid eye disease. / Kim, Minjae; Yang, Sungwon; Park, Jinhwan; Lee, Hwa; Baek, Se Hyun.

In: Journal of Korean Ophthalmological Society, Vol. 59, No. 7, 01.07.2018, p. 599-605.

Research output: Contribution to journalArticle

@article{8feb79a1aa804d8387c6c83222133fec,
title = "Risk factors for structural changes in meibomian gland in thyroid eye disease",
abstract = "Purpose: To investigate the effect of clinical activity score (CAS) and thyroid stimulating hormone receptor autoantibody (TSHR autoantibody) on structural changes in Meibomian gland in patients with thyroid eye disease (TED). Methods: From March 2015 to February 2016, retrospective and cross-sectional studies were performed on patients diagnosed with TED. We investigated thyroid function, TSHR autoantibody (thyrotopin-binding inhibitor immunoglobulin [TBII] assay) status, duration of TED, CAS, and analyzed the Meibomian gland structure using a Lipiview inferometer{\circledR} (TearScience Inc., Morrisville, NC, USA). We evaluated the degree of meibum expression (ME) and the tear film breakdown time by slit lamp microscopy. Results: A total of 37 patients (13 males and 24 females) with TED were included in the study, and the mean age was 43.8 ± 13.3 years. At the time of the study, 24 patients (64.9{\%}) had hyperthyroidism, five patients (13.5{\%}) had hypothyroidism, and eight patients (21.6{\%}) had normal functioning. The mean CAS was 1.86 ± 1.74 (0-7), nine patients (24.3{\%}) were in the active group with ≥3 points of CAS, and 28 patients (75.7{\%}) were in the inactive group with <3 points of CAS. The meiboscore was 1.05 ± 0.82 in the upper eyelid, and 0.76 ± 0.76 in the lower eyelid, with a significantly higher upper eyelid (p = 0.001). The mean value of the TBII was 6.11 ± 11.35 IU/L. Sixteen patients (43.2{\%}) had TBII above the normal 1.5 value, and 21 patients (56.8{\%}) had a normal TBII. The meiboscore of the upper eyelid was significantly higher when the TBII was higher than normal (p = 0.045). CAS (r = 0.356, p = 0.030), ME (r = 0.379, p = 0.021), and TBII (r = 0.334, p = 0.044) were significantly associated with the meiboscore in the upper eyelid. Using multiple regression analyses, CAS (p = 0.010) and TBII (p = 0.011) were factors affecting the upper eyelid meiboscore, and CAS (p = 0.015) and TBII (p = 0.038) were factors affecting the lower eyelid meiboscore. Conclusions: The structural loss of Meibomian glands in patients with TED was greater in the upper eyelid than lower eyelid, and CAS and TSHR autoantibody had an effect on the structural loss of the Meibomian gland.",
keywords = "Clinical activity score, Meibomian gland dysfunction, Meiboscore, Thyroid eye disease, Thyroid stimulating hormone receptor autoantibody",
author = "Minjae Kim and Sungwon Yang and Jinhwan Park and Hwa Lee and Baek, {Se Hyun}",
year = "2018",
month = "7",
day = "1",
doi = "10.3341/jkos.2018.59.7.599",
language = "English",
volume = "59",
pages = "599--605",
journal = "Journal of Korean Ophthalmological Society",
issn = "0378-6471",
publisher = "Korean Ophthalmological Society",
number = "7",

}

TY - JOUR

T1 - Risk factors for structural changes in meibomian gland in thyroid eye disease

AU - Kim, Minjae

AU - Yang, Sungwon

AU - Park, Jinhwan

AU - Lee, Hwa

AU - Baek, Se Hyun

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Purpose: To investigate the effect of clinical activity score (CAS) and thyroid stimulating hormone receptor autoantibody (TSHR autoantibody) on structural changes in Meibomian gland in patients with thyroid eye disease (TED). Methods: From March 2015 to February 2016, retrospective and cross-sectional studies were performed on patients diagnosed with TED. We investigated thyroid function, TSHR autoantibody (thyrotopin-binding inhibitor immunoglobulin [TBII] assay) status, duration of TED, CAS, and analyzed the Meibomian gland structure using a Lipiview inferometer® (TearScience Inc., Morrisville, NC, USA). We evaluated the degree of meibum expression (ME) and the tear film breakdown time by slit lamp microscopy. Results: A total of 37 patients (13 males and 24 females) with TED were included in the study, and the mean age was 43.8 ± 13.3 years. At the time of the study, 24 patients (64.9%) had hyperthyroidism, five patients (13.5%) had hypothyroidism, and eight patients (21.6%) had normal functioning. The mean CAS was 1.86 ± 1.74 (0-7), nine patients (24.3%) were in the active group with ≥3 points of CAS, and 28 patients (75.7%) were in the inactive group with <3 points of CAS. The meiboscore was 1.05 ± 0.82 in the upper eyelid, and 0.76 ± 0.76 in the lower eyelid, with a significantly higher upper eyelid (p = 0.001). The mean value of the TBII was 6.11 ± 11.35 IU/L. Sixteen patients (43.2%) had TBII above the normal 1.5 value, and 21 patients (56.8%) had a normal TBII. The meiboscore of the upper eyelid was significantly higher when the TBII was higher than normal (p = 0.045). CAS (r = 0.356, p = 0.030), ME (r = 0.379, p = 0.021), and TBII (r = 0.334, p = 0.044) were significantly associated with the meiboscore in the upper eyelid. Using multiple regression analyses, CAS (p = 0.010) and TBII (p = 0.011) were factors affecting the upper eyelid meiboscore, and CAS (p = 0.015) and TBII (p = 0.038) were factors affecting the lower eyelid meiboscore. Conclusions: The structural loss of Meibomian glands in patients with TED was greater in the upper eyelid than lower eyelid, and CAS and TSHR autoantibody had an effect on the structural loss of the Meibomian gland.

AB - Purpose: To investigate the effect of clinical activity score (CAS) and thyroid stimulating hormone receptor autoantibody (TSHR autoantibody) on structural changes in Meibomian gland in patients with thyroid eye disease (TED). Methods: From March 2015 to February 2016, retrospective and cross-sectional studies were performed on patients diagnosed with TED. We investigated thyroid function, TSHR autoantibody (thyrotopin-binding inhibitor immunoglobulin [TBII] assay) status, duration of TED, CAS, and analyzed the Meibomian gland structure using a Lipiview inferometer® (TearScience Inc., Morrisville, NC, USA). We evaluated the degree of meibum expression (ME) and the tear film breakdown time by slit lamp microscopy. Results: A total of 37 patients (13 males and 24 females) with TED were included in the study, and the mean age was 43.8 ± 13.3 years. At the time of the study, 24 patients (64.9%) had hyperthyroidism, five patients (13.5%) had hypothyroidism, and eight patients (21.6%) had normal functioning. The mean CAS was 1.86 ± 1.74 (0-7), nine patients (24.3%) were in the active group with ≥3 points of CAS, and 28 patients (75.7%) were in the inactive group with <3 points of CAS. The meiboscore was 1.05 ± 0.82 in the upper eyelid, and 0.76 ± 0.76 in the lower eyelid, with a significantly higher upper eyelid (p = 0.001). The mean value of the TBII was 6.11 ± 11.35 IU/L. Sixteen patients (43.2%) had TBII above the normal 1.5 value, and 21 patients (56.8%) had a normal TBII. The meiboscore of the upper eyelid was significantly higher when the TBII was higher than normal (p = 0.045). CAS (r = 0.356, p = 0.030), ME (r = 0.379, p = 0.021), and TBII (r = 0.334, p = 0.044) were significantly associated with the meiboscore in the upper eyelid. Using multiple regression analyses, CAS (p = 0.010) and TBII (p = 0.011) were factors affecting the upper eyelid meiboscore, and CAS (p = 0.015) and TBII (p = 0.038) were factors affecting the lower eyelid meiboscore. Conclusions: The structural loss of Meibomian glands in patients with TED was greater in the upper eyelid than lower eyelid, and CAS and TSHR autoantibody had an effect on the structural loss of the Meibomian gland.

KW - Clinical activity score

KW - Meibomian gland dysfunction

KW - Meiboscore

KW - Thyroid eye disease

KW - Thyroid stimulating hormone receptor autoantibody

UR - http://www.scopus.com/inward/record.url?scp=85052018840&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052018840&partnerID=8YFLogxK

U2 - 10.3341/jkos.2018.59.7.599

DO - 10.3341/jkos.2018.59.7.599

M3 - Article

VL - 59

SP - 599

EP - 605

JO - Journal of Korean Ophthalmological Society

JF - Journal of Korean Ophthalmological Society

SN - 0378-6471

IS - 7

ER -