title: [Tear film analysis and its relation with palpebral fissure height and exophthalmos in Graves' ophthalmopathy].
abstract: OBJECTIVE
  To evaluate tear film quality by rose bengal staining and its stability by breakup time, relating with palpebral fissure height and exophthalmos in patients with Graves' ophthalmopathy.
  
  
  METHODS
  We studied 54 eyes of 27 patients with Graves' ophthalmopathy, either in the inflammatory or in the chronic phase of the disease. The evaluation consisted of tear film qualitative analysis by rose bengal staining using the van Bijsterveld grading scale, tear film stability analysis by breakup time, measurement of palpebral fissure height and exophthalmometry. Qui square test was used to perform statistical analysis.
  
  
  RESULTS
  Among 27 studied patients, 77.8% were females and 22.2% males. Mean age was 44.26 years (SD 12.67). Mean disease time was 5.85 years (SD 4.47) and mean ophthalmopathy time was 5.81 years (SD 5.37). Among 54 studied eyes, 37% had positive test by van Bijsterveld's grading scale, 33.3% tear film breakup time lower than 5 seconds, 57.4% palpebral fissure height greater than 11 mm and 55.6% exophthalmometry greater than 19 mm. When relating tear film breakup time lower than 5 seconds with palpebral fissure height greater than 11 mm we found an odds ratio of 11.2 (p=0.0008). The remaining relationships did not show statistical significance.
  
  
  CONCLUSIONS
  Dry eye diagnosed by rose bengal staining and tear film breakup time occurs frequently in Graves' ophthalmopathy. Palpebral fissure height correlates with tear film breakup time in Graves' ophthalmopathy. Its increase may lead to tear film instability.
authors.affiliation: Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ. llmv@unisys.com.br
authors.forename: Maria Vitoria Oliveira Moura
authors.initials: MV
authors.lastname: Brasil
authors.forename: Oswaldo Ferreira Moura
authors.initials: OF
authors.lastname: Brasil
authors.forename: Rodrigo Perez
authors.initials: RP
authors.lastname: Vieira
authors.forename: Mário
authors.initials: M
authors.lastname: Vaisman
authors.forename: Octávio Moura Brasil do
authors.initials: OM
authors.lastname: Amaral Filho
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005143:Eyelids / Q000033:anatomy & histology*; D005260:Female; D005456:Fluorescent Dyes; D049970:Graves Ophthalmopathy / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012395:Rose Bengal; D013666:Tears; D013997:Time Factors; D014985:Xerophthalmia / Q000175:diagnosis / Q000209:etiology*
chemical_list: D005456:Fluorescent Dyes; D012395:Rose Bengal