ÖZET
Amaç: Tiroid oftalmopatili (TO) olgularda klinik siniflama, tiroid hormon degerleri, otoantikor pozitifligi ve ekzoftalmus derecesi ile göziçi basinç (GIB) iliskisini degerlendirmek.
Gereç ve Yöntem: Klinigimizde TO nedeni ile izlenen 102 olgu çalismaya dahil edildi. Olgularin NO SPECS kriterlerine göre klinik siniflandirilmasi yapildi. Serbest T3, serbest T4, total TSH, antitiroglobulin antikor (TGAb) ve antitiroidperoksidaz (TPOAb) degerleri çalisildi. Ekzoftalmus dereceleri Hertel ekzoftalmometresi ile belirlendi. Tüm olgularin GIB'lari primer ve yukari bakis pozisyonunda Goldmann aplanasyon tonometresi ile ölçüldü. Elde edilen veriler istatistiksel olarak Pearson ki-kare, Fischer ki-kare analizi, Spearman ve Pearson korelasyon katsayisi, tek yönlü varyans analizi ve student t testi ile degerlendirildi.
Bulgular: Çalismamizda, TO olgularinda NO SPECS siniflamasindaki artisa paralel olarak primer ve yukari bakista GIB'inda yükselme saptandi (p<0.001). Tiroid hormon degerleri ile GIB arasinda iliski saptanmadi (p>0.05). TPOAb ve TGAb degerlerinin pozitif veya negatif olmasinin GIB üzerinde etkisi bulunmadi (p>0.05). GIB degerlerinin, ekzoftalmus derecesindeki artisa paralel olarak primer ve yukari bakis pozisyonunda arttigi saptandi (p<0.001).
Sonuç: Klinikte TO'li olgular degerlendirilirken, NO SPECS klinik skorlama ve ekzoftalmus derecesinin GIB artisi üzerindeki etkisi göz önünde bulundurulmalidir.
Anahtar Kelimeler: Tiroid oftalmopati, Göz içi basinci, Ekzoftalmus, Tiroid hormonlari, Tiroid otoantikorlari
Effects of Thyroid Hormone Level, Clinical Classification Autoantibody and
Exophthalmos Degree on IOP in Thyroid Ophthalmopathy
SUMMARY
Purpose: To investigate whether if there is any relationship between levels of serum thyroid hormone, thyroid auto-antibodies, NO SPECS classification, exophthalmos degree and intraocular pressure (IOP) in patients with thyroid ophthalmopathy.
Material and Methods: One hundred and two patients with thyroid ophthalmopathy were included in the study. Patients were classified by NO SPECS criteria. Free T3, free T4, total thyroid stimulating hormone (TSH), antithyroglobulin antibody (TGAb) and antithyroid peroxidase antibody (TPOAb) were studied. Exophthalmos measurements were performed using Hertel exophthalmometry. Intraocular pressure was measured using Goldmann applanation tonometry in primary position and upgaze. Statistical analyses were performed using Pearson chi-square test, Fischer chi-square test, Pearson correlation test, Spearman correlation test and student t test.
Results: There was a statistically significant increase in intraocular pressure in primary position and upgaze regarding NO SPECS classification (p<0.001). However, no significant correlation was present between thyroid hormone value and intraocular pressure in primary position and upgaze (p>0.05). No significant correlations were detected between intraocular pressure and the values of thyroid autoantibodies, either (p>0.05). The correlation between intraocular pressure and exophthalmos degree was significant. Intraocular pressure was elevated by increasing the exophthalmos degree in primary position and upgaze (p>0.001).
Conclusion: Effects of NO SPECS classification and exophthalmos degree on intraocular pressure should be taken into consideration in the evaluation of patients with thyroid ophthalmopathy.
Key Words: Thyroid ophthalmopathy, Intraocular pressure, Exophthalmos, Thyroid hormone, Thyroid autoantibodies
