Evaluation of Dry Eye Parameters in Patients with Papillary Thyroid Carcinoma.

Background/

Objectives

Dry eye disease (DED) is now widely considered to be the most prevalent ocular surface-related disease and has attracted increasing clinical attention in recent years. DED is well-studied in thyroid orbitopathy, but scarce data are available in patients with papillary thyroid carcinoma (PTC).

Methods

We analyzed 29 PTC cases with radioactive iodine (RAI) treatment (Group 1), 22 PTC cases without RAI (Group 2), and 26 normal control individuals (Group 3). All participants were evaluated with the Ocular Surface Disease Index (OSDI), meibomian gland secretion quality, and lid margin grading. Non-contact meibography and non-invasive tear breakup time measurements were completed using the Sirius Scheimpflug camera. Thyrotropin (TSH), free thyroxine, and free triiodothyronine were measured.

Results

TSH values were significantly lower in both patient groups than in controls (p < 0.001). The proportion of participants with a lower meibomian gland secretion quality score ≥ 1 was 34.5% in Group 1, 22.7% in Group 2, and 7.1% in Group 3 (p = 0.002). There was a higher proportion of a meibomian gland atrophy score ≥ 1 in Groups 1 and 2 than in controls (p = 0.007). No differences were found between groups in lower lid margin score, Oxford values, upper meibomian gland expressibility or upper meibography scores (p = 0.485, p = 0.064, p = 0.256, p = 0.069). OSDI scores were higher in both PTC groups than in controls (6.25 and 8.12 vs. 2.52), with borderline overall significance (p = 0.050) and higher pairwise scores versus controls (both p = 0.034).

Conclusions

Meibomian gland dysfunction was observed in PTC patients regardless of RAI treatment, suggesting that TSH suppression itself may contribute to the development of ocular surface changes.