scholarly journals Lacrimal system pathology in patients with malignant thyroid tumors after radioactive iodine therapy, and its correction methods

2017 ◽  
Vol 10 (4) ◽  
pp. 13-17
Author(s):  
Natalya Yu Beldovskaya ◽  
Sergey A Karpichenko ◽  
Svetlana V Baranskaya ◽  
Artemiy A Karpov

Introduction. Radioactive iodine therapy after thyroidectomy is the standard of differentiated thyroid cancer treatment in the modern world. Main dose-dependent side effects described in the literature include: sialadenitis, xerostomia, taste and/or odor loss, swelling of surrounding tissues. Ophthalmic complications are rarely reported. Aim. To assess the lacrimal system condition in patients after radioactive iodine therapy for thyroid cancer. Material and methods. The study included 17 patients (34 eyes). There were female patients aged 19 to 43 years (mean age was 31 years) who underwent a course of radioactive iodine therapy for thyroid cancer. All of them complained of periodic or constant tearing in the period from 2 months to 1 year after therapy course. In four patients, there was a permanent or periodic mucopurulent discharge when pressing on the lacrimal sac area. All patients underwent a standard ophthalmological examination, including visual acuity testing, anterior segment biomicroscopy, ophthalmoscopy, and tear production tests. Dye disappearance test, Jones I and II tests, lacrimal pathways irrigation, and, if necessary, cone-ray computer tomography with preliminary lacrimal pathways contrasting were performed to evaluate the tear outflow abnormalities. Results. Tear production disorders were detected in 20 eyes (58.8%) (among them, moderate dry eye syndrome was diagnosed in 3 cases); tear outflow pathology was revealed in 14 eyes (41.2%) (namely naso-lacrimal duct obstruction and stenosis, and chronic purulent dacryocystitis). For patients with tear production pathology artificial tears were prescribed, and endoscopic endonasal dacryocystorhinostomy was performed in cases of tear outflow disturbances. Conclusion. The use of radioactive iodine in doses exceeding 80 mCi leads to the development of lacrimal system pathology: dry eye syndrome of various severity, and tear outflow disorders. Lacrimal system pathology significantly worsens the patient's quality of life, and the prophylaxis of these diseases before the radioactive iodine therapy course remains the imminent key problem. (For citation: Beldovskaya NYu, Karpishchenko SA, Baranskaya SV, Karpov AA. Lacrimal system pathology in patients with ­malignant thyroid tumors after radioactive iodine therapy, and its correction methods. ­Ophthalmology Journal. 2017;10(4):13-17. doi: 10.17816/OV10413-17).

2019 ◽  
Vol 16 (1) ◽  
pp. 70-75
Author(s):  
L. I. Uchakova ◽  
S. V. Balalin ◽  
V. L. Zagrebin

The aim is to evaluate the effectiveness of Stillavit in the treatment of dry eye syndrome (DES) and its effect on the density of conjunctival goblet cells and the functional parameters of tear production. Methods. There were analyzed treatment results of 18 patients (36 eyes) with DES at the age of 48 to 80 years (average 60.6 ± 1.3 years) including 17 women and 1 male before and after 1 and 3 months after Stillavit prescription. In all patients in addition to a standard ophthalmological examination the results of Schirmer I, Norn, as well as the LIPCOF test were evaluated and the density of conjunctival goblet cells was examined. Results. After 1 and 3 months there was a significant improvement in the results of the Norn test: from 5.17 ± 0.22 seconds to 7.18 ± 0.17 seconds which indicated an increase in the stability of the tear film. After 3 months there was a significant increase in the density of conjunctival goblet cells, improvement in the Schirmer sample: from 9.26 ± 0.89 to 11.7 ± 0.6 mm (t = 2.28, p < 0.05) and LIPCOF test (t = 2.18, p < 0.05) which indicated an increase in tear production and a significant decrease in the inflammatory process and edema of the conjunctiva. Conclusion. Treatment of DES with the use of Stillavit leads after 3 months to a significant increase in the density of conjunctival goblet cells, increases tear production and stability of the tear film.


2003 ◽  
Vol 89 (1) ◽  
pp. 68-74 ◽  
Author(s):  
Edward Rosenblatt ◽  
Olga R Brook ◽  
Nurit Erlich ◽  
Benjamin Miller ◽  
Henry Z Joachims ◽  
...  

Aims and Background Classical irradiation of carcinoma of the nasopharynx involves large fields and high doses; therefore, significant late toxicity and late side effects are to be expected. Given the fact that nasopharyngeal carcinoma (NPC) is a relatively radiosensitive disease and a significant proportion of patients are long-term survivors, late visual and auditory complications of treatment are of utmost concern for patients and radiation oncologists. The aim of this study was to evaluate the long-term visual and auditory toxicity in patients treated with radiotherapy for NPC. Methods and Study Design Forty-three long-term survivors (including 11 children), following definitive radiotherapy for NPC, underwent a thorough visual and auditory evaluation 2–22 years after their treatment. Ophthalmological examination consisted of anamnesis of dry eye syndrome and visual acuity, visual acuity testing, slit-lamp examination, Schirmer test, fundus examination, and intraocular pressure measurement, as well as fluorescein angiography in patients with pathological vascular findings in the fundus examination. Audiological evaluation included anamnesis of hearing loss, tinnitus or vertigo, examination of the ears and nasopharynx, audiogram, and tympanogram. Results Radiation retinopathy was found in 16% of patients by fundus examination, with one patient (2.3%) developing blindness. Severe dry eye syndrome was present in 26%. Fifty-six percent had some degree of hearing impairment, with 74% showing severe sensorineural hearing loss. Fifty-eight percent of patients reported tinnitus and 26% reported suffering from dizziness. Radiation retinopathy as well as all manifestations of auditory toxicity were found to bear a direct correlation with dose per fraction. Conclusions Unless there is tumor involvement, the orbital contents should be completely excluded from the target volume. Auditory toxicity is significant when treating NPC with two-dimensional techniques.


2011 ◽  
pp. P3-658-P3-658
Author(s):  
Hwa Young Ahn ◽  
Ah Reum Kang ◽  
Yul Hwang Bo ◽  
Kyung Won Kim ◽  
Young Joo Park ◽  
...  

2021 ◽  
pp. 6-11
Author(s):  
K.N. Odinaeva ◽  
◽  
N.S. Al Khateeb ◽  
M.A. Frolov ◽  
◽  
...  

Purpose. To determine and study the features of the development of dry eye syndrome (DES) in gout, depending on urate-lowering therapy, the duration of the gout disease and the concentration of uric acid in the tear. Material and methods. The study involved 149 male patients (261 eyes) aged 35 to 75 years (mean age 60.63 ± 11.00 years). Among them, 110 people (202 eyes) with an established diagnosis: "Cataract with concomitant gout disease" and 39 people (59 eyes) with cataracts without clinical and laboratory signs of gout. All patients underwent both standard ophthalmological examinations and special ones. The concentration of uric acid in tears was determined by high performance liquid chromatography (HPLC). The diagnosis of gout was confirmed according to the criteria recommended by ACR / EULAR (2016). Results. In patients with gout who do not take a urate-lowering drug, DES occurs more often (82.1%) than in patients without gout (23.1%). With an increase in the concentration of uric acid in the tear, there is a high tendency to a shortening of the tear film rupture time (strong correlation coefficient r=-0.51, p<0.001) and to a decrease in tear production (Schirmer I test) (strong correlation coefficient r=-0.59, p<0.001). Conclusion. The data obtained indicate clear changes in the functional parameters of total tear production (Schirmer I's test) and the stability of the pre-corneal tear film (Norn's test) in patients with gout. This can be considered as a fact of the predisposition of this category of patients to the development of DES. A strong dependence of changes in tear production and HRVP on the concentration of uric acid in the tear was established. There is an obvious need for additional examination of this category of patients and an adequate choice of therapy, as well as the timely appointment of "artificial tear" drugs. Key words: dry eye syndrome, uric acid, gout.


2016 ◽  
Vol 44 (6) ◽  
pp. 926-934 ◽  
Author(s):  
Arnoldo Piccardo ◽  
Matteo Puntoni ◽  
Gianluca Bottoni ◽  
Giorgio Treglia ◽  
Luca Foppiani ◽  
...  

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