Clinical Report: Ocular Symptoms and Immune Characteristics in Thyroid Eye Disease

Overview

This study investigates the ocular manifestations and immunological profiles of thyroid eye disease (TED) with lacrimal gland enlargement. Findings indicate that patients with enlarged lacrimal glands experience worse proptosis and unstable tear film, with elevated thyroid peroxidase antibody levels and Treg cells correlating with gland enlargement.

Background

Thyroid eye disease (TED) is a common autoimmune condition associated with Graves' disease, leading to significant ocular symptoms. The involvement of the lacrimal glands in TED can exacerbate symptoms and impact the quality of life. Understanding the immunological characteristics and ocular manifestations associated with lacrimal gland enlargement is crucial.

Data Highlights

Key Findings

• Patients with enlarged lacrimal glands exhibited worse proptosis compared to those with normal glands.
• Decreased tear film break-up time (TBUT) was observed in the enlarged lacrimal gland group.
• Increased Schirmer I test values were noted in patients with lacrimal gland enlargement.
• Elevated thyroid peroxidase antibody (TPO-Ab) levels were associated with lacrimal gland enlargement.
• The proportions of CD8+ T cells and regulatory T (Treg) cells were significantly higher in the enlarged lacrimal gland group.
• TPO-Ab and Treg cell proportions were identified as independent factors influencing lacrimal gland enlargement in TED.

Clinical Implications

The findings suggest that monitoring TPO-Ab levels and Treg cell frequencies may provide insights into the progression of lacrimal gland involvement in TED. Clinicians should consider these factors when assessing and managing patients with TED.

Conclusion

Lacrimal gland enlargement in TED is associated with significant ocular symptoms and specific immunological changes.

Related Resources & Content

1. Contact Lens Spectrum, 2026 -- Dry Eye Dx and Tx: Thinking About Thyroid Eye Disease
2. Frontiers in Endocrinology, 2026 -- Diagnosis and treatment progress of upper eyelid abnormalities in thyroid-eye disease
3. Contact Lens Spectrum, 1997 -- Dry Eye: A Common And Complicated Problem
4. Guidelines and consensus frameworks, 2021 -- EUGOGO clinical practice guideline
5. Contact Lens Spectrum — ONLINE PHOTO DIAGNOSIS
6. https://academic.oup.com/ejendo/article/185/4/G43/6654384
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8. Diagnostic Accuracy of MRI-Based Dixon and T2 Localization Techniques for Imaging Severity and Progression in Thyroid-Associated Ocular Diseases