1. PREVALENCE OF DECREASED THYROID STATUS IN PATIENTS WITH PRIMARY OPEN ANGLE GLAUCOMA
Igor Alekseev1,2, Elena Iomdina3, Marina Aliverdieva1, Anna Stulova4, Olga Nepesova5
1FSBEI FPE RMACPE MOH, Moscow, Russian Federation
2Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation;
3Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russian Federation;
4Lomonosov Moscow State University, Moscow, Russian Federation;
5Branch of the Federal Budgetary Institution of Healthcare «Medical Rehabilitation Centre of the Ministry of Economic Development of Russia», Moscow, Russian Federation.
Introduction
Results
Results (Continued)
One of the strategic objectives for the health care system is improving the screening program for glaucoma, а serious eye disease that leads to blindness if left untreated. The screening program detects glaucoma in time, in order to start treatment and to stabilize the condition. The screening program requires constant analysis and improvement, which was the basis of this study [1].
The mean level of T4 was significantly lower in the glaucoma group (15.05±2.2 mmol/l), as compared to the control group (20.65±14.5 mmol/l), p=0.05 (Fig.1).
Levels of cholesterol and TG tended to be higher in the POAG group. In 70.4% of patients, the level of cholesterol was above normal (against 63.2% in the control subjects) and in 12,7% in the patients the TG level was above normal (with 7.9% of the control subjects) (Fig. 3).
Conclusion
The root causes of POAG remain completely unknown, but the accumulation of data on the relationship between glaucoma and other chronic diseases leads to a new paradigm for its diagnosis and control. This disease should be viewed not as an isolated pathology of the visual organ, but as a multifactor system, whose development and progress is affected by its general status. Studies in this direction are promising, especially in the case of the detection of modifiable aspects, especially in the detection of manageable risk factors, such as hypothyroidism [2-8].
The results of this study suggests that the hormonal profile changes in the thyroid gland can be associated with POAG development.
Ostensibly, thyroid disorders may be considered as a potential risk factor of primary open-angle glaucoma development.
Figure 1. Levels of free T4 and TSH in control and the POAG groups.
Purpose
The structure of the endocrinology diagnoses were analyzed and it was established that the nodular goiter and chronic autoimmune thyroiditis were detected more often in the glaucoma group (31.34% and 11.94% versus the control group: 21.92% and 6.85%, respectively) (Fig. 2).
The purpose of this study was to establish whether the thyroid hormonal levels could be used in glaucoma screening. Revealing groups at high risk within the framework of their examination can help in the early diagnosis of glaucoma.
Methods
Medical records of patients under treatment with open-angle glaucoma (POAG) from 2015 to 2016 were reviewed retrospectively.
The retrospective study involved 71 patients (57 women, 14 men) in the POAG group and 76 patients (52 women, 24 men) in the control group. The average age of patients in the POAG group was 67.12±6.47 years, and in the control group ±5.97 years (p>0.5).
To evaluate the thyroid function, mean levels were used from the thyroid-stimulating hormone (TSH), free thyroxine (T4), anti-thyroid peroxidase antibodies, and the endocrinologist’s report. Additionally, biochemical blood indicators were measured: levels of glucose, cholesterol, high and low density lipoproteins (HDL, LDL), and triglycerides (TG).
Figure 2. Structure of endocrinology diagnoses in control and the POAG groups
References
The blood glucose level in patients with POAG and in the control group did not significantly differ. In the patients with POAG, type 2 diabetes mellitus was registered at an increase of 3.7 (9.86% POAG Group verses 2.63% in the Control Group). (Figure 2)
Moyer V., LeFevre M.L., Siu A.L. Screening for glaucoma: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2013; 159(7): doi: /
Lee A.J., Rochtchina E., Healey P.R., et al. Open-angle glaucoma and systemic thyroid disease in an older population: The Blue Mountains Eye Study. Eye 2004; 18: doi: /sj.eye
Lin H.C., Kang J.H., Jiang Y.D., Ho J.D. Hypothyroidism and the Risk of Developing Open-Angle Glaucoma. Ophthalmology 2010; 117(10): doi: /j.ophtha
Cross J.M., Girkin С.А., Owsley С., McGwin Jr. The Association between Thyroid Problems and Glaucoma. PLoS One 2015; 10(7):e doi: /bjo
Smith K.D., Arthurs B.P., Saheb N. An association between hypothyroidism and primary open-angle glaucoma. Ophthalmology 1993; 100:1580–1584.
Kakigi С., Kasuga T., Wang S., Singh K., Hiratsuka Y., Murakami A. Hypothyroidism and Glaucoma in The United States. PLoSOne. 2015; 10(7):e doi: /journal.pone
Karadimas P, Bouzas EA, Topouzis F, et al. Hypothyroidism and glaucoma. A study of 100 hypothyroid patients. Am J Ophthalmol 2001; 131:126–128. doi: /s (00)
Motsko S.P., Jones J.K. Is there an association between hypothyroidism and open-angle glaucoma in an elderly population? An epidemiologic study. Ophthalmology 2008; 115(9): doi: /j.ophtha
For further information
Please contact
Figure 3. Frequency of abnormal levels of cholesterol, LDL, HDL and TG in control and the POAG groups.