关键词: 甲状腺相关性眼病, 免疫抑制剂, 眼表

Abstract:

Objective To observe the ocular surface changes of thyroid associated ophthalmopathy (TAO) before and after immunosuppressive agents pulse therapy. Design Prospective comparative case series. Participants TAO patients and normal controls, 30 cases (60 eyes) respectively. Method The group of TAO patients received methylprednisolone 0.5 g in 250 ml physiological saline and cyclophosphamide 0.2 g in 500 ml physiological saline for intravenous drop, 1 times a day, for 3 days of shock treatment. The subjects were then proceeded for clinical examinations and recorded of ocular indexes of them. Main Outcome Measures exophthalmos, palpebral fissure height, blinking, cornea fluorescein staining (FL), fluorescein break-up time (FBUT), Schirmer I test (SIT), and Ocular Surface Disease Index (OSDI) of these subjects. Results There were significant difference in every observation index of ocular surface mentioned above between normal subjects and TAO patients before immunosuppressive (all P=0.000).There were no significant difference in recorded of exophthalmos (P=0.083), palpebral fissure height (P=0.091) between TAO patients before and after immunosuppressive agents pulse therapy. After immunosuppressive agents pulse therapy, TAO patients have less blinking times (P=0.000), lower FL (P=0.001), shorter FBUT (P=0.000), longer SIT (P=0.000) and lower OSDI (P=0.000) with statistic significant differences. Conclusions The damage of ocular surface in TAO patients is obvious. The ocular surface of TAO patients can be improved by immunosuppressive agents pulse therapy, and its mechanism may be through inhibition of ocular surface inflammation and the effect of lacrimal gland first.  (Ophthalmol CHN, 2016, 25: 40-44)

Key words:  thyroid associated ophthalmopathy, immunosuppressive agents, ocular surface