The effect of high-dose radioiodine treatment on lacrimal gland function in patients with differentiated thyroid carcinoma.
OBJECTIVE
There are a limited number of case reports confirming the radioiodine (I-131) presence in tears and only a few case reports of lacrimal gland dysfunction after I-131 therapy. This study was designed to clarify whether lacrimal gland function can be affected by I-131 therapy.


METHODS
We studied 100 eyes of 50 patients who had received high doses of I-131 for treatment of differentiated thyroid carcinoma and 100 eyes of 50 age- and sex-matched control individuals without a history of interfering conditions. The exposed group was studied at least 3 months after their last I-131 therapy. Dry eye symptoms and Schirmer test values (wetting level in millimeters per 5 minutes) of an exposed group were compared with those of an unexposed group.


RESULTS
Fifty-one percent of the exposed eyes and 50% of the unexposed ones revealed at least 1 of the dry eye symptoms. There was no significant difference in symptoms between 2 groups, except for burning sensation and eye redness, which were significantly higher in the exposed eyes. A lower Schirmer test value was noted in the exposed group, 14.5 +/- 10.8 mm, when compared with that in controls, 18.2 +/- 11.0 mm (P = 0.016), and the relative risk of an abnormal Schirmer test in exposed cases to control group was 1.78 +/- 0.62. Correlation coefficient analysis showed no significant relationship between Schirmer test values and cumulative doses of administered I-131.


CONCLUSIONS
Reduction in the tear secretion from lacrimal glands is seen after high-dose I-131 therapy; however, their symptoms are no greater than an unexposed population.
Fard-Esfahani
Armaghan
A
Research Institute for Nuclear Medicine, Medical Sciences/University of Tehran, Shariati Hospital, Tehran, Iran.
Mirshekarpour
Hossein
H
Fallahi
Babak
B
Eftekhari
Mohammad
M
Saghari
Mohsen
M
Beiki
Davood
D
Ansari-Gilani
Kianoush
K
Takavar
Abbas
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use; D007765:Lacrimal Apparatus / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology*; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000532:radiotherapy; D016896:Treatment Outcome
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals