Abstract:
Introduction. Dry eye syndrome (DES) is associated with a complicated
multifactorial mechanism, the peculiarities of which are being studied at the
moment. Data on tear production disorders in hypothyroidism and on disturbances
in activity of enzymes providing homeostasis of reduced glutathione in DES
underline the need to study metabolic alterations in lacrimal gland function in
patients with hypothyroidism.
Purpose. To study the character of metabolic alterations in the tear fluid in primary
hypothyroidism patients with DES.
Material and Methods. We examined 78 patients with primary hypothyroidism.
Among the patients, there were 16 subclinical hypothyroidism patients without
DES (hypothyroidism-only group) and 62 patients with DES (hypothyroidism+DES
group) (hypothyroidism type: subclinical, 32 patients; manifest, 30 patients;
hypothyroidism compensation: compensation, 28 patients; subcompensation, 20
patients; decompensation, 14 patients). 16 healthy volunteers served as controls.
Results. Hypothyroidism patients had more pronounced biochemical changes
in the tear fluid in manifest hypothyroidism with DES and decompensated
hypothyroidism: the increased activity of acid phosphatase, lactate dehydrogenase,
and malate dehydrogenase; disorders in the thiol status against the background of
the increased malondialdehyde level.
Conclusions. The increased activity of dehydrogenases and acid phosphatase as
well as of malondialdehyde against the background of the decreased thiol status
in the tear fluid can testify to destruction in cells and subcellular structures of the
corneal epithelium in hypothyroidism accompanied with DES that is caused by the
action of both lipid peroxidation products and lysosomal enzymes.
