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DOI: 10.5146/tjpath.2019.01461
Changes in Conjunctiva Morphology Using Impression Cytology in Patients with Hashimoto’s Thyroiditis without Thyroid-Associated Ophthalmopathy
Mustafa ALTAY1, Tuğba ŞAHİN2, Zennure YILDIZ2, Gülçin ŞİMŞEK3, Mehmet ÇITIRIK4, İhsan ATEŞ5, Murat DAĞDEVİREN1, Muharrem BİTİREN3
1Department of Endocrinology and Metabolism, University of Health Sciences, Keçiören Health Administration and Research Center, ANKARA, TURKEY
2Department of Ophthalmology, University of Health Sciences, Keçiören Health Administration and Research Center, ANKARA, TURKEY
3Department of Pathology, University of Health Sciences, Keçiören Health Administration and Research Center, ANKARA, TURKEY
4Department of Ophthalmology, University of Health Sciences, Ulucanlar Health Administration and Research Center, ANKARA, TURKEY
5Department of Internal Medicine, University of Health Sciences, Ankara Numune Health Administration and Research Center, ANKARA, TURKEY
Keywords: Anti-TPO, Conjunctival impression cytology, Hashimoto’s thyroiditis, Inflammation

Objective: To compare the conjunctival morphological changes in patients with Hashimoto’s thyroiditis (HT) without thyroid-associated ophthalmopathy (TAO) and controls using impression cytology technique.

Material and Method: We included 25 HT patients and 33 healthy controls who did not have TAO findings or dry eye. For both groups, thyroid stimulating hormone (TSH), free T4(FT4), and anti-thyroid peroxidase (anti-TPO) were measured. Thyroid ultrasonography was performed, together with all routine eye check-ups and the Schirmer’s test. Also, conjunctival impression cytology (CIC) test was performed to analyze the conjunctival morphology.

Results: When the CIC of HT patients was observed; 12% had grade 0, 40% had grade 1, 28% had grade 2 and 20% had grade 3. While patients with squamous metaplasia made up 48% of the HT group, this was observed at 6.1% in the control group (p < 0,001). In the regression model formulated, it was observed that obesity (OR=7.500; p=0.017) and anti TPO levels (OR=1.370, p=0,007) were independent stipulations for the squamous metaplasia.

Conclusion: Conjunctival squamous metaplasia was more frequently seen in HT than controls and serum Anti-TPO level and obesity were detected as independent predictors of the worsening at the conjunctival impression cytology.


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