Thyroid Disease May Increase Dry Eye Disease Risk

Thyroid disease may be a risk factor for developing dry eye disease (DED), according to a study published in Contact Lens and Anterior Eye.

Researchers enrolled 400 patients who visited a single center with dry eye complaints in a cross-sectional study. Participants completed the Ocular Surface Disease Index (OSDI) and underwent tear osmolarity, corneal staining, and tear film breakup time (TFBUT) measurements from an observer who was masked to their OSDI scores. The investigators stratified participants into 1 of 4 cohorts based on dry eye disease signs and symptoms which included no DED (n=56; mean age, 24.3 years; 46.4% men; OSDI score, 6.0), preclinical DED (n=30; mean age, 32.6 years; 30% men; OSDI score, 26.4), predisposition to DED (n=107; mean age, 35.1 years; 27.1% men; OSDI score, 7.0), and DED (n=207; mean age, 46.2 years; 18.8 % men; OSDI score, 31.7) and performed analyses between participants with no DED and individuals in the other cohorts. The study’s objective was to investigate correlations between DED and its risk factors, both modifiable and nonmodifiable, while adjusting for antihistamine intake. 

“The physiopathology and treatment of systemic diseases like rheumatoid arthritis, and thyroid disease can impact the normal function of the ocular surface, while medication for treating common diseases like allergy or depression has side effects that affect the ocular surface function,” the study authors explained. “These disorders and the medication for their treatment are commonly prescribed in daily clinical practice and may be important risk factors for DED due to their high prevalence (. . .).”

The multivariable logistic regression analysis determined that thyroid disease was a possible risk factor for DED (odds ratio [OR], 4.53; 95 % CI, 1.04-19.73; Fisher’s exact, P =.044; Crameŕs V=0.140; P =.024). However, the report states that no association was observed between the studied parameters and pre-clinical DED (Fisher’s exact, all P ≥.398; Crameŕs V, all P ≥.242) or predisposition to DED (Fisher’s exact, all P ≥.065; Crameŕs V, all P ≥.031).

“Thyroid disorders are highly prevalent, endocrine conditions that affect the function of most organs in the body, and it is one of the most frequent complications of pregnancy and endocrine disorder in infants or children,” according to the researchers. “This condition did not seem to be a non-modifiable risk factor in the Pre-clinical or Predisposition DED status groups however.”

Study limitations include a limited sample of participants with rheumatoid arthritis and individuals who used diuretics and the possible misclassification of participants with neurotrophic conditions as having preclinical DED or predisposition to DED.