Ocular surface inflammation, and nerve growth factor level in tears in active thyroid-associated ophthalmopathy.
OBJECTIVE
To measure tear nerve growth factor (NGF) concentrations in cases of active thyroid-associated ophthalmopathy (TAO) before and after glucocorticoid treatment, and to correlate NGF levels with disease inflammatory activity and thyroid autoantibody concentration.


METHODS
The study involved 20 patients with active TAO and 20 age- and gender-matched controls. Tear break-up time (BUT) was obtained, the Schirmer test was performed, and tear NGF/total protein ratio was measured in control subjects and patients with active TAO before, and 2 and 4 weeks after, steroid treatment.


RESULTS
Tear BUT and Schirmer values significantly increased after 2 and 4 weeks of steroid treatment (p < 0.001 and p = 0.004 respectively). Baseline tear NGF/total protein ratio was higher in patients with active TAO than in control subjects, and the ratio significantly decreased after 2 and 4 weeks of steroid treatment (p < 0.001). Tear NGF/total protein ratio did not correlate with inflammatory activity score, exophthalmos value and thyroid binding inhibiting immunoglobulin (TBII) level (p > 0.05).


CONCLUSIONS
Tear NGF may have a specific role in ocular surface inflammation, which protects against ocular surface damage in patients with active TAO. Anti-inflammatory treatment significantly reduced the level of NGF in tears, increased tear film stability and production, and decreased congestive symptoms.
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seodaemungu Shinchondong 134, Seoul 120-752, Korea.
Jin Sook
JS
Yoon
Soo Hyun
SH
Choi
Joon H
JH
Lee
Sung Jun
SJ
Lee
Sang Yeul
SY
Lee
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D049970:Graves Ophthalmopathy / Q000150:complications* / Q000276:immunology; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000276:immunology; D008297:Male; D008875:Middle Aged; D020932:Nerve Growth Factor / Q000378:metabolism*; D015423:Scleritis / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism*; D013666:Tears / Q000276:immunology / Q000378:metabolism*; D013967:Thyroiditis, Autoimmune / Q000150:complications / Q000276:immunology; D055815:Young Adult
D001323:Autoantibodies; D005938:Glucocorticoids; D020932:Nerve Growth Factor