Evaluation of Tear Secretion in Thyroid Patients in Relation to the Thyroid Status and Previous I131 Treatment for Thyroid Cancer

Abstract

Aims: To evaluate tear secretion of thyroid patients with no clinical evidence of thyroid ophthalmopathy in relation to thyroid status and history of I131 treatment by the use of the 2-minute Schirmer test I (test without topical anesthesia). Study Design: Prospective study. Place and Duration of Study: 1st University Eye Clinic, AHEPA Hospital, Thessaloniki, Greece and Laboratory of Experimental Ophthalmology, Aristotle University of Thessaloniki, Greece, between June 2013 and July 2014. Methodology: 128 consecutive thyroid patients, 111 females and 17 males, aged from 18 to 82 years 49.48±14.61 (mean±sd) were recruited for this study. None of the thyroid patients had clinical signs or symptoms of thyroid ophthalmopathy. 49 of them had history of I131 treatment for thyroid carcinoma. The 2-min Schirmer test I was performed on the same day the patients underwent the routine exams for thyroid hormones. As abnormal were considered Schirmer test I values <10 mm. Results: Out of 49 thyroid patients with history of I131 therapeutic treatment, 35 (71.4%) had 2-minute Schirmer test I values <10 mm. However there was no statistically significant difference in relation to their thyroid status. Regarding patients, with no previous I131 treatment, 55 out of 79 patients (71.4%) had Schirmer test I values <10 mm and there was no statistically significant difference in relation to their thyroid status. There was no statistically significant difference in Schirmer test I values between patients who received I131 and those who did not. Conclusion: Thyroid patients without clinical evidence of thyroid ophthalmopathy have impaired Schirmer test I scores irrespective of the thyroid status and previous I131 exposure and thus they more likely to develop ocular surface abnormalities. Patients with previous I131 treatment had no statistically significant differences in the tear secretion values as compared with the non-irradiated thyroid patients.