Clinical Significance of Corneal Striae in Thyroid Associated Orbitopathy

• Published in: Journal of clinical medicine 2023-03, Vol.12 (6), p.2284
• Main Authors: Liao, Xulin, Aljufairi, Fatema Mohamed Ali Abdulla, Lai, Kenneth Ka Hei, Chan, Karen Kar Wun, Jia, Ruofan, Chen, Wanxue, Hu, Zhichao, Wei, Yingying, Chu, Winnie Chiu Wing, Tham, Clement Chee Yung, Pang, Chi Pui, Chong, Kelvin Kam Lung
• Format: Article
• Language: English
• Subjects: Analysis; Care and treatment; Clinical medicine; Clinical significance; Cornea; Diagnosis; Eye; Graves disease; Magnetic resonance imaging; Medical examination; Regression analysis; Scanners; Thyroid eye disease; Thyroid gland
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12062284

To elucidate the clinical implications of corneal striae (CS) in thyroid associated orbitopathy (TAO) patients. In this cross-sectional study, the presence of CS was confirmed after topical fluorescein staining on a slit lamp for consecutive treatment-naive TAO patients. Orbital parameters, including margin reflex distances, lagophthalmos, exophthalmos, intraocular pressure and radiological measurements, were compared between eyes with and without CS. The largest cross-sectional areas of each rectus muscle were measured by segmenting the T1-weighted (T1W) magnetic resonance images (MRI). The logistic regression analyses were used to evaluate the associations between CS and orbital parameters and rectus muscle measurements. Fifty-three consecutive TAO patients (presenting age 46.47 ± 14.73 years, clinical activity score 1.77 ± 1.25) who had unilateral CS were enrolled. In univariate analysis, both the degree of lagophthalmos and the area of the levator palpebrae superioris-superior rectus complex (LPS/SR) on T1W MRI were significantly larger in CS eyes compared to eyes without CS ( < 0.05). Multivariate analyses showed that CS in TAO patients were significantly associated with the degree of lagophthalmos (OR = 1.75, 95% CI: 1.18-2.61, < 0.05) and LPS/SR area (OR = 19.27, 95% CI: 1.43-259.32, < 0.05) but not with the other parameters. CS could predict LPS/SR enlargement and larger lagophthalmos in TAO ( < 0.05). The largest cross-sectional areas of LPS/SR and inferior rectus were positively correlated with clinical activity scores ( < 0.05). The presence of CS in TAO eye is significantly associated with LPS/SR enlargement and worse lagophthalmos. CS might be evaluated further as a potential ocular surface biomarker to identify upper lid and LPS/SR involvement in TAO.