Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Tiroid Fonksiyon Bozukluğunda Uygulanan Antitiroid Tedavinin Oküler Yüzey Üzerine Etkisi
The Effect of Antithyroid Treatment on Ocular Surface in Thyroid Dysfunction Patients
İrem AKÖZ ÖZTÜRKa, Dicle HAZIROLANb, Emine DOĞANc, Dilek DELLALd, Uğur Emrah ALTIPARMAKe, Hüseyin ÜSTÜNf, Nurten ÜNLÜb
aGöz Hastalıkları Kliniği, Eskişehir Devlet Hastanesi, Eskişehir, TÜRKİYE
bGöz Hastalıkları Kliniği,
fPatoloji Kliniği, Ankara Eğitim ve Araştırma Hastanesi, Ankara, TÜRKİYE
cGöz Hastalıkları Kliniği, Sakarya Eğitim ve Araştırma Hastanesi, Sakarya, TÜRKİYE dEndokrinoloji ve Metabolizma Hastalıkları Kliniği, Ankara Atatürk Eğitim ve Araştırma Hastanesi, eGöz Hastalıkları Kliniği, Acıbadem Ankara Hastanesi, Ankara, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2019;28(2):80-5
doi: 10.5336/ophthal.2018-61563
Article Language: TR
Full Text
ÖZET
 Amaç: Tiroid fonksiyon bozukluğu nedeni ile uygulanan antitiroid tedavinin oküler yüzey ve kuru göz üzerine etkisini değerlendirmektir. Gereç ve Yöntemler: Tiroid fonksiyon bozukluğu mevcut olup, oftalmopatisi olmayan 5 hastanın 50 gözü çalışmaya dâhil edildi. Hastaların 12?si yeni tanı almış ve henüz sistemik medikal tedaviye başlanmamış (Grup 1), 13?ü ise daha önce (en az 4 ay) tanı almış ve tedavi başlanmış hastalardı (Grup 2). Tüm hastalara tam oftalmolojik muayene, gözyaşı kırılma zamanı (GKZ), anestezisiz Schirmer testi ve impresyon sitolojisi uygulandı. Bulgular: Grup 1?de yer alan sekizi kadın, dördü erkek 12 olgunun yaş ortalaması 38,2±5,4 yıl iken; Grup 2?de yer alan yedisi kadın, altısı erkek 13 hastanın yaş ortalaması 44,8±10,0 yıl idi. Grup 1?de ortalama Schirmer değeri 11,25±10,73 mm iken, Grup 2?de 10,80±6,42 mm idi. GKZ Grup 1?de ortalama 9,37±5,02 sn, Grup 2?de ise 8,73±4,06 sn olarak saptandı. Nelson kriterlerine göre yapılan impresyon skorlamasında, Grup 1?de 17 (%70,8) gözde, Grup 2?de 17 (%65,3) gözde Evre 1 ve 2 skuamöz metaplazi bulundu. Her iki grup arasında GKZ, Schirmer testi ve impresyon skorlaması yönünden istatistiksel olarak anlamlı bir fark yoktu. Sonuç: Çalışmamızın sonucunda, tiroid fonksiyon bozukluğu olup; antitiroid tedavi alan ve almayan hasta gruplarının her ikisinde de oküler yüzey bozukluğu saptanmıştır. Bu nedenle, tiroid fonksiyon bozukluğu saptanan hastalara antitiroid tedaviden bağımsız olarak kuru göz tedavisinin başlanması faydalı olabilmektedir.

Anahtar Kelimeler: Tiroid; impresyon sitolojisi; kuru göz; oküler yüzey; antitiroid tedavi
ABSTRACT
 Objective: To eveluate the effect of antithyroid treatment on ocular surface and dry eye in thyroid dysfunction patients. Material and Methods: Fifty eyes of twenty five patients with thyroid dysfunction without ophthalmopathy were included in this study. Twelve of the patients were newly diagnosed and previously untreated (Group 1). Thirteen of the patients (Group 2) were treated with antithyroid treatment at least 4 months. Ophtalmologic examination, Schirmer tear test without anesthesia, tear break-up time and conjunctival impression cytology were perfomed in all patients. Results: Mean age of 12 (8 female, 4 male) patients was 38.2±5.4 years in Group 1 and 13 (7 female, 6 male) patients was 44.8±10.0 years in Group 2. The mean Schirmer tear test score was 11.25±10.73 mm and 10.80±6.42 mm in Group 1 and Group 2 respectively. The mean tear brake up time was 9.37±5.02 sec in Group 1 and 8.73±4.06 sec in Group 2. Impression cytology which is made according to Nelson Criteria showed Grade 1 and 2 squamous metaplasia 17 (70.8%) patients in Group 1 and 17 (65.3%) patients in Group 2. There were no statistically differences in the Schirmer tear test score, tear brake up time and impression cytology between the groups. Conclusions: In our study ocular surface inflammation was detected in both patients group with and without antithyroid treatment. Therefore, regardless of antithyroid treatment, dry eye treatment may be useful in all patients with thyroid disfunctions.

Keywords: Thyroid; impression cytology; dry eye; ocular surface; antithyroid treatment
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