Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy

Mahmoud Elsamkary; Heba Isaa; Radwa Elsherif

doi:doi:10.11648/j.ijovs.20210604.20

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Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy

Mahmoud Elsamkary, Heba Isaa, Radwa Elsherif

Published in International Journal of Ophthalmology & Visual Science (Volume 6, Issue 4)

Received: 8 November 2021 Accepted: 3 December 2021 Published: 9 December 2021

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Abstract

Aim: to evaluate the inflammatory and morphological changes in conjunctival cells and the relationship to the degree of proptosis for helping early diagnosis of thyroid -associated eye disease. Subjects and methods: cross sectional observational prospective study that included 40 patients complain from proptosis of thyroid eye disease attended to Ain shams university, Cairo, from May 2019 to November 2020 with control 40 normal person. Exclusion criteria included patients with History of surgical correction of thyroid eye disease, auto immune disease, Previous Lasik surgery, recent Intraocular surgery, diabetic patients and patients under steroid or immune suppressive treatment. All patients were subjected to History taking of thyroid disease with laboratory investigations to assess the thyroid functions, visual acuity measurement, intraocular pressure, Hertel's exophthalmometry for measurement of the degree of proptosis, color vision using Ishihara’s test, Funds examination and Conjunctival impression cytology. Images were taken using an Olympus CX31 microscope fitted with an Olympus E-620 camera. Results: The degree of inflammation in impression cytology showed that most of thyroid eye disease group is in moderate degree (80%) 32 cases, while the rest (20%) is between mild degree of inflammation (15%) 6 cases and severe degree of inflammation (5%) 2 cases. No statistically significant relation found between degree of proptosis and severity of inflammation of right and left eye with p-value = 0.650 and 0.331 respectively. Morphologically, most of thyroid eye disease group showed stage 2 in impression cytology results (65%) 26 cases, while the rest (35%) between stage 4, 3, 1 (5%, 15%, 15%, respectively). Conclusion: Detection of inflammatory and morphological changes occurring in conjunctiva of cases with thyroid –associated Ophthalmopathy by impression cytology can help in early diagnosis of thyroid-associated Ophthalmopathy patients even before appearance of other eye symptoms.

Published in	International Journal of Ophthalmology & Visual Science (Volume 6, Issue 4)
DOI	10.11648/j.ijovs.20210604.20
Page(s)	247-251
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Thyroid Disease, Proptosis, Inflammatory Changes, Impression Cytology

References

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[3]	Roos JCP, Murthy R. Update on the clinical assessment and management of thyroid eye disease. Curr Opin Ophthalmol. 2019; 30: 401-406.
[4]	Scruggs RT, Black EH. Thyroid eye disease with significant levator involvement and ptosis: a case report. Ophthalmic plastic and reconstructive surgery. 2015; 31 (6): e153-4.
[5]	Douglas R. Teprotumumab, an insulin-like growth factor-1 receptor antagonist antibody, in the treatment of active thyroid eye disease: a focus on proptosis. Eye (Lord). 2019; 33: 183-190.
[6]	Li Z, Cestari DM, Fortin E. Thyroid eye disease: what is new to know? Curr Opin Ophthalmol. 2018; 29: 529-534.
[7]	Thia ZZ, Tong L. Update on the role of impression cytology in ocular surface disease. Taiwan Jophthalmol. 2019; 9: 141-9.
[8]	López-Miguel A, Gutiérrez-Gutiérrez S, García- Vázquez C, Enríquez-de-Salamanca A. RNA collection from human conjunctival epithelial cells obtained with a new device for impression cytology. Cornea. 2017; 36 (1): 59-63.
[9]	Thakre A, Maheshgauri R, Aggarwal M, Mantri P, Naik A. Role of impression cytology in ocular surface disorders. IP International Journal of ocular oncology and oculoplasty. 2020; 6 (1): 42-7.
[10]	Allam IY, Lazreg S, Shaheen MS, Doheim MF, Mohammed MA. Ocular surface changes in patients with Thyroid Eye disease: An Observational clinical study. Clinical Ophthalmology. 2021: (15): 2481-88.
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[15]	Wang Y, Smith TJ. Current concepts in the molecular pathogenesis of thyroid-associated ophthalmopathy. Invest Ophthalmol Vis Sci. 2014; 55 (3): 1735–48.

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APA Style

Mahmoud Elsamkary, Heba Isaa, Radwa Elsherif. (2021). Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy. International Journal of Ophthalmology & Visual Science, 6(4), 247-251. https://doi.org/10.11648/j.ijovs.20210604.20

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ACS Style

Mahmoud Elsamkary; Heba Isaa; Radwa Elsherif. Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy. Int. J. Ophthalmol. Vis. Sci. 2021, 6(4), 247-251. doi: 10.11648/j.ijovs.20210604.20

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AMA Style

Mahmoud Elsamkary, Heba Isaa, Radwa Elsherif. Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy. Int J Ophthalmol Vis Sci. 2021;6(4):247-251. doi: 10.11648/j.ijovs.20210604.20

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@article{10.11648/j.ijovs.20210604.20,
  author = {Mahmoud Elsamkary and Heba Isaa and Radwa Elsherif},
  title = {Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {6},
  number = {4},
  pages = {247-251},
  doi = {10.11648/j.ijovs.20210604.20},
  url = {https://doi.org/10.11648/j.ijovs.20210604.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20210604.20},
  abstract = {Aim: to evaluate the inflammatory and morphological changes in conjunctival cells and the relationship to the degree of proptosis for helping early diagnosis of thyroid -associated eye disease. Subjects and methods: cross sectional observational prospective study that included 40 patients complain from proptosis of thyroid eye disease attended to Ain shams university, Cairo, from May 2019 to November 2020 with control 40 normal person. Exclusion criteria included patients with History of surgical correction of thyroid eye disease, auto immune disease, Previous Lasik surgery, recent Intraocular surgery, diabetic patients and patients under steroid or immune suppressive treatment. All patients were subjected to History taking of thyroid disease with laboratory investigations to assess the thyroid functions, visual acuity measurement, intraocular pressure, Hertel's exophthalmometry for measurement of the degree of proptosis, color vision using Ishihara’s test, Funds examination and Conjunctival impression cytology. Images were taken using an Olympus CX31 microscope fitted with an Olympus E-620 camera. Results: The degree of inflammation in impression cytology showed that most of thyroid eye disease group is in moderate degree (80%) 32 cases, while the rest (20%) is between mild degree of inflammation (15%) 6 cases and severe degree of inflammation (5%) 2 cases. No statistically significant relation found between degree of proptosis and severity of inflammation of right and left eye with p-value = 0.650 and 0.331 respectively. Morphologically, most of thyroid eye disease group showed stage 2 in impression cytology results (65%) 26 cases, while the rest (35%) between stage 4, 3, 1 (5%, 15%, 15%, respectively). Conclusion: Detection of inflammatory and morphological changes occurring in conjunctiva of cases with thyroid –associated Ophthalmopathy by impression cytology can help in early diagnosis of thyroid-associated Ophthalmopathy patients even before appearance of other eye symptoms.},
 year = {2021}
}

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TY  - JOUR
T1  - Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy
AU  - Mahmoud Elsamkary
AU  - Heba Isaa
AU  - Radwa Elsherif
Y1  - 2021/12/09
PY  - 2021
N1  - https://doi.org/10.11648/j.ijovs.20210604.20
DO  - 10.11648/j.ijovs.20210604.20
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 247
EP  - 251
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20210604.20
AB  - Aim: to evaluate the inflammatory and morphological changes in conjunctival cells and the relationship to the degree of proptosis for helping early diagnosis of thyroid -associated eye disease. Subjects and methods: cross sectional observational prospective study that included 40 patients complain from proptosis of thyroid eye disease attended to Ain shams university, Cairo, from May 2019 to November 2020 with control 40 normal person. Exclusion criteria included patients with History of surgical correction of thyroid eye disease, auto immune disease, Previous Lasik surgery, recent Intraocular surgery, diabetic patients and patients under steroid or immune suppressive treatment. All patients were subjected to History taking of thyroid disease with laboratory investigations to assess the thyroid functions, visual acuity measurement, intraocular pressure, Hertel's exophthalmometry for measurement of the degree of proptosis, color vision using Ishihara’s test, Funds examination and Conjunctival impression cytology. Images were taken using an Olympus CX31 microscope fitted with an Olympus E-620 camera. Results: The degree of inflammation in impression cytology showed that most of thyroid eye disease group is in moderate degree (80%) 32 cases, while the rest (20%) is between mild degree of inflammation (15%) 6 cases and severe degree of inflammation (5%) 2 cases. No statistically significant relation found between degree of proptosis and severity of inflammation of right and left eye with p-value = 0.650 and 0.331 respectively. Morphologically, most of thyroid eye disease group showed stage 2 in impression cytology results (65%) 26 cases, while the rest (35%) between stage 4, 3, 1 (5%, 15%, 15%, respectively). Conclusion: Detection of inflammatory and morphological changes occurring in conjunctiva of cases with thyroid –associated Ophthalmopathy by impression cytology can help in early diagnosis of thyroid-associated Ophthalmopathy patients even before appearance of other eye symptoms.
VL  - 6
IS  - 4
ER  -

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Author Information

Mahmoud Elsamkary

Faculty of Medicine, Ain Shams University, Cairo, Egypt
Heba Isaa

Research Institute of Ophthalmology, Cairo, Egypt
Radwa Elsherif

Faculty of Medicine, Ain Shams University, Cairo, Egypt

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APA Style

Mahmoud Elsamkary, Heba Isaa, Radwa Elsherif. (2021). Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy. International Journal of Ophthalmology & Visual Science, 6(4), 247-251. https://doi.org/10.11648/j.ijovs.20210604.20

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ACS Style

Mahmoud Elsamkary; Heba Isaa; Radwa Elsherif. Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy. Int. J. Ophthalmol. Vis. Sci. 2021, 6(4), 247-251. doi: 10.11648/j.ijovs.20210604.20

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AMA Style

Mahmoud Elsamkary, Heba Isaa, Radwa Elsherif. Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy. Int J Ophthalmol Vis Sci. 2021;6(4):247-251. doi: 10.11648/j.ijovs.20210604.20

Copy | Download

@article{10.11648/j.ijovs.20210604.20,
  author = {Mahmoud Elsamkary and Heba Isaa and Radwa Elsherif},
  title = {Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {6},
  number = {4},
  pages = {247-251},
  doi = {10.11648/j.ijovs.20210604.20},
  url = {https://doi.org/10.11648/j.ijovs.20210604.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20210604.20},
  abstract = {Aim: to evaluate the inflammatory and morphological changes in conjunctival cells and the relationship to the degree of proptosis for helping early diagnosis of thyroid -associated eye disease. Subjects and methods: cross sectional observational prospective study that included 40 patients complain from proptosis of thyroid eye disease attended to Ain shams university, Cairo, from May 2019 to November 2020 with control 40 normal person. Exclusion criteria included patients with History of surgical correction of thyroid eye disease, auto immune disease, Previous Lasik surgery, recent Intraocular surgery, diabetic patients and patients under steroid or immune suppressive treatment. All patients were subjected to History taking of thyroid disease with laboratory investigations to assess the thyroid functions, visual acuity measurement, intraocular pressure, Hertel's exophthalmometry for measurement of the degree of proptosis, color vision using Ishihara’s test, Funds examination and Conjunctival impression cytology. Images were taken using an Olympus CX31 microscope fitted with an Olympus E-620 camera. Results: The degree of inflammation in impression cytology showed that most of thyroid eye disease group is in moderate degree (80%) 32 cases, while the rest (20%) is between mild degree of inflammation (15%) 6 cases and severe degree of inflammation (5%) 2 cases. No statistically significant relation found between degree of proptosis and severity of inflammation of right and left eye with p-value = 0.650 and 0.331 respectively. Morphologically, most of thyroid eye disease group showed stage 2 in impression cytology results (65%) 26 cases, while the rest (35%) between stage 4, 3, 1 (5%, 15%, 15%, respectively). Conclusion: Detection of inflammatory and morphological changes occurring in conjunctiva of cases with thyroid –associated Ophthalmopathy by impression cytology can help in early diagnosis of thyroid-associated Ophthalmopathy patients even before appearance of other eye symptoms.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy
AU  - Mahmoud Elsamkary
AU  - Heba Isaa
AU  - Radwa Elsherif
Y1  - 2021/12/09
PY  - 2021
N1  - https://doi.org/10.11648/j.ijovs.20210604.20
DO  - 10.11648/j.ijovs.20210604.20
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 247
EP  - 251
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20210604.20
AB  - Aim: to evaluate the inflammatory and morphological changes in conjunctival cells and the relationship to the degree of proptosis for helping early diagnosis of thyroid -associated eye disease. Subjects and methods: cross sectional observational prospective study that included 40 patients complain from proptosis of thyroid eye disease attended to Ain shams university, Cairo, from May 2019 to November 2020 with control 40 normal person. Exclusion criteria included patients with History of surgical correction of thyroid eye disease, auto immune disease, Previous Lasik surgery, recent Intraocular surgery, diabetic patients and patients under steroid or immune suppressive treatment. All patients were subjected to History taking of thyroid disease with laboratory investigations to assess the thyroid functions, visual acuity measurement, intraocular pressure, Hertel's exophthalmometry for measurement of the degree of proptosis, color vision using Ishihara’s test, Funds examination and Conjunctival impression cytology. Images were taken using an Olympus CX31 microscope fitted with an Olympus E-620 camera. Results: The degree of inflammation in impression cytology showed that most of thyroid eye disease group is in moderate degree (80%) 32 cases, while the rest (20%) is between mild degree of inflammation (15%) 6 cases and severe degree of inflammation (5%) 2 cases. No statistically significant relation found between degree of proptosis and severity of inflammation of right and left eye with p-value = 0.650 and 0.331 respectively. Morphologically, most of thyroid eye disease group showed stage 2 in impression cytology results (65%) 26 cases, while the rest (35%) between stage 4, 3, 1 (5%, 15%, 15%, respectively). Conclusion: Detection of inflammatory and morphological changes occurring in conjunctiva of cases with thyroid –associated Ophthalmopathy by impression cytology can help in early diagnosis of thyroid-associated Ophthalmopathy patients even before appearance of other eye symptoms.
VL  - 6
IS  - 4
ER  -

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