To investigate the ocular manifestations and immunological profiles of thyroid eye disease (TED) with lacrimal gland enlargement.
Approach:
Study Design: Cross-sectional study enrolling TED patients, categorized into enlarged lacrimal gland (ELG) and normal lacrimal gland (NLG) groups based on MRI measurements.
Patient Enrollment: Patients diagnosed with TED were included, excluding those with prior treatments or conditions affecting lacrimal gland size.
Comparative Analysis: Ocular manifestations, thyroid function tests, and immunological examinations were compared between ELG and NLG groups.
Key Findings:
123 TED patients were enrolled (NLG: 36, ELG: 87).
ELG patients exhibited worse proptosis (P < 0.05), decreased tear film break-up time (TBUT) (P < 0.05), and increased Schirmer I test values (P < 0.05) compared to NLG.
Elevated thyroid peroxidase antibody (TPO-Ab) levels were found in the ELG group (P < 0.05).
Proportions of CD8+ T cells and regulatory T (Treg) cells were significantly higher in the ELG group (P < 0.05).
Serum TPO-Ab levels and Treg cell proportions correlated significantly with lacrimal gland area (P < 0.05).
Interpretation:
TPO-Ab and Treg cells are positively correlated with lacrimal gland enlargement in TED, with Treg cell frequency serving as a predictive biomarker.
Limitations:
The study was limited to patients who had not received systemic glucocorticoids or immunosuppressants, which may affect the generalizability of the findings.
Exclusion of patients with other diseases affecting lacrimal gland size may limit generalizability.
Conclusion:
TED patients with enlarged lacrimal glands showed worse ocular symptoms, and TPO-Ab and Treg cells were identified as independent factors for lacrimal gland enlargement.
