Correlation between the Thyroid Associated Ophthalmopathy and Thyroid Function State

PURPOSE: To determine the prevalence of thyroid-associated ophthalmopathy (TAO) and the correlation between TAO and the thyroid function state. METHODS: 40 patients with TAO were selected among 2,000 patients of thyroid disease between September 1, 1995 and December 31, 2000, and classified by the Van Dyk's ''NOSPECS and RELIEF'' classification. T3, T4, TSH and Thyroid stimulating antibody (TSAb) levels were examined before and after treatment of TAO and thyroid disease. Relationship between TAO and thyroid function state was evaluated by using paired t-test and logistic regression test. RESULTS: The prevalence of TAO was about 2% in thyroid disease patients. Clinical manifestations of TAO were eyelid retraction (75%), exophthalmos (62.5%), soft tissue periorbital swelling (42.5%), diplopia and extraocular muscle restriction (20%), keratopathy (2.5%) and optic neuropathy (2.5%). Thyroid function state decided by T3, T4 and TSH level had no correlation with the improvement of TAO (p<0.05). But, TSAb level in improved TAO group (n=8) significantly decreased after treatment of TAO and thyroid disease (p<0.05). CONCLUSIONS: Thyroid function restoration may not help to improve the course of TAO. But, low TSAb level can be thought as a significant marker in improvement of TAO.

Visual Prognosis and the Development of After-cataract following Cataract Surgery in Atopic Dermatitis

PURPOSE: To investigate the visual prognosis, the interval, and the rate of development of after-cataract following cataract surgery in atopic dermatitis. METHODS: Twenty eyes of 13 patients diagnosed as cataract associated with atopic dermatitis were operated between January, 1994 and January, 2000. Visual acuity, postoperative inflammatory reaction, the interval, and the rate of development of after-cataract were investigated and compared with the cataract cases without atopic dermatitis. RESULTS: The average preoperative best corrected visual acuity of 20 eyes was 0.23+/-0.22. The average postoperative best corrected visual acuity at 1, 2, 7, and 12 months after surgery were 0.78+/-0.23, 0.83+/-0.16, 0.78+/-0.23, 0.83+/-0.26, respectively. These values showed no significant difference compared to the postoperative visual acuity of the cataract cases without atopic dermatitis. Aqueous flares measured with laser flare meter were 15.09+/-9.20, 11.15+/-4.68, and 7.38+/-0.75 photon counts/millisecond at 10 days, 1, and 2 months after surgery, which did not seem to influence the final visual acuity and the development of after-cataract (p>0.05). Among the 20 eyes, 66.67% finally developed after-cataract and the average time interval of the development of after-cataract was 11.25+/-4.22 months. CONCLUSIONS: Visual prognosis following cataract surgery in atopic dermatitis is good, while after-cataract seems to develop more frequently and earlier compared to the cases without atopic dermatitis.