Hipotireoidismo e glaucoma: investigação de uma possível associação

Costa, Vital P.; Suzuki, Ricardo; Costa, Ana Paula A. C.; Honda, Michel; Ritch, Robert; Knobel, Meyer; Medeiros-Neto, Geraldo

doi:10.5935/0004-2749.19980096

RESUMO

Objetivo:

Investigar a associação entre glaucoma primário de ângulo aberto (GP AA) e hipotireoidismo.

Métodos:

No primeiro estudo, 15 pacientes com hipotireoidismo primário que não estavam recebendo complementação hormonal foram investigados quanto à presença de GPA A. No segundo estudo, 65 pacientes com GPAA foram investigados quanto à ocorrência de hipotireoidismo através da dosagem de TSH.

Resultados:

Nenhum dos 15 pacientes com hipotireoidismo apresentou dados compatíveis com o diagnóstico de GPA A, e o nível médio da pressão intraocular nesses pacientes foi de 15,8 ± 2,3 mmHg, variando entre 11 e 21 mmHg. Apenas um (1,5%) entre os 65 pacientes glaucomatosos apresentou hipotireoidismo subclínico, diagnosticado graças aos níveis elevados de TSH.

Conclusão:

Os achados deste estudo não confirmam a hipótese de uma associação entre hipotireoidismo e GPAA.

Palavras-chave:
Glaucoma; Hipotireoidismo; Tireóide; Pressão Intraocular

SUMMARY

Purpose:

To investigate the association between primary open-angle glaucoma (POAG) and hypothyroidism.

Methods:

In the first study, 15 patients with hypothyroidism were analyzed to verify the presence of POAG. In the second study, a TSH assay was employed as a screening test to determine the incidence of hypothyroidism in 65 patients with POAG.

Results:

None of the 15 patients with hypothyroidism had clinical findings compatible with POAG, and the mean intraocular pressure measurements were 15.8 ± 2.3 mmHg (range 11 to 21 mmHg). Only one (1.5%) of the 65 POAG patients showed abnormal TSH levels, and was diagnosed as having subclinical hypothyroidsm.

Conclusion:

These findings do not support the existence of a positive correlation between hypothyroidism and POAG.

Key words:
Glaucoma; Hypothyroidism; Thyroid; Intraocular Pressure

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REFERÊNCIAS BIBLIOGRÁFICAS

¹
Greenspan FS, Baxter JD. Basic & Clinical Endocrinology. 4th ed. Appleton & Lange, Connecticut, USA, 1994, pp.l71-190.
²
Hertel G. Einiges über den Augendruck und Glaukom. Klin Monatsbl Augenheilkd 1920;64:390-392.
³
Ritch R, Podos SM. Hypothyroidism and glaucoma (letter). Ophthalmology 1994;101:623-4.
⁴
Smith KD, Tevaarwerk GJM, Allen LH. Reversal of poorly controlled glaucoma upon diagnosis and treatment of hypothytoidism. Can J Ophthalmol 1992;27:345-7.
⁵
Smith KD, Tevaarwerk GJM, Allen LH. An ocular dynamic study supporting the hypothesis that hypothyroidism is a treatable cause of secondary open angle glaucoma. Can J Ophthalmol 1992;27:341-4.
⁶
Pestereva AA. Early diagnosis, treatment and prevention of disorders of intraocular pressure and hydrodynamics in patients with hypothyroidism in the Carpathian region. Ophthalmol Zh 1988;4:215-8.
⁷
Mclenachan J, Davies DM. Glaucoma and the Thyroid. Br J Ophthalmol 1965;49:441-4.
⁸
Smith KD, Arthurs BP, Saheb N. An association between hypothyroidism and primary open-angle glaucoma. Ophthalmology 1993; 100:1580-4.
⁹
Stein R, Romano A, Treister G, Bartov E. Effect of subconjunctival injection of hyaluronidase on outflow resistance in normal and in open-angle glaucomatous patients. Metab Pediatr Syst Ophthalmol 1982;6:169-74.
¹⁰
Góes-Monteiro R. Contribuição ao estudo da pressão intra-ocular normal em brasileiros. Rev Bras Oftalmol 1972;31 :317-25.
¹¹
Goldmann H, Schmidt T. ^Üeber Applanationstonometrie. Ophthalmologica 1956;134:221-42.
¹²
Cheng H, Perkins ES. Thyroid disease and glaucoma. Br J Ophthalmol 1967;51:547-53.
¹³
Krupin T, Jacobs LS, Podos SM, Becker B. Thyroid function and the intraocular pressure response to topical corticosteroids. Am J Ophthalmol 1977;83:643-6.
¹⁴
Cartwright MJ, Grajewski AL, Friedberg ML, Anderson DR Richards DW. Immune-related disease and normal-tension glaucoma: A case control study. Arch. Ophthalmol 1992;110:500-2.
¹⁵
Jämsen, K. - Thyroid disease, a risk factor for optic neuropathy mimicking normal-tension glaucoma. Acta Ophthalmol Scand 1996;74:456-60.

Datas de Publicação

Publicação nesta coleção
Feb 1998

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.

[1] ¹
Greenspan FS, Baxter JD. Basic & Clinical Endocrinology. 4th ed. Appleton & Lange, Connecticut, USA, 1994, pp.l71-190.

[2] ²
Hertel G. Einiges über den Augendruck und Glaukom. Klin Monatsbl Augenheilkd 1920;64:390-392.

[3] ³
Ritch R, Podos SM. Hypothyroidism and glaucoma (letter). Ophthalmology 1994;101:623-4.

[4] ⁴
Smith KD, Tevaarwerk GJM, Allen LH. Reversal of poorly controlled glaucoma upon diagnosis and treatment of hypothytoidism. Can J Ophthalmol 1992;27:345-7.

[5] ⁵
Smith KD, Tevaarwerk GJM, Allen LH. An ocular dynamic study supporting the hypothesis that hypothyroidism is a treatable cause of secondary open angle glaucoma. Can J Ophthalmol 1992;27:341-4.

[6] ⁶
Pestereva AA. Early diagnosis, treatment and prevention of disorders of intraocular pressure and hydrodynamics in patients with hypothyroidism in the Carpathian region. Ophthalmol Zh 1988;4:215-8.

[7] ⁷
Mclenachan J, Davies DM. Glaucoma and the Thyroid. Br J Ophthalmol 1965;49:441-4.

[8] ⁸
Smith KD, Arthurs BP, Saheb N. An association between hypothyroidism and primary open-angle glaucoma. Ophthalmology 1993; 100:1580-4.

[9] ⁹
Stein R, Romano A, Treister G, Bartov E. Effect of subconjunctival injection of hyaluronidase on outflow resistance in normal and in open-angle glaucomatous patients. Metab Pediatr Syst Ophthalmol 1982;6:169-74.

[10] ¹⁰
Góes-Monteiro R. Contribuição ao estudo da pressão intra-ocular normal em brasileiros. Rev Bras Oftalmol 1972;31 :317-25.

[11] ¹¹
Goldmann H, Schmidt T. ^Üeber Applanationstonometrie. Ophthalmologica 1956;134:221-42.

[12] ¹²
Cheng H, Perkins ES. Thyroid disease and glaucoma. Br J Ophthalmol 1967;51:547-53.

[13] ¹³
Krupin T, Jacobs LS, Podos SM, Becker B. Thyroid function and the intraocular pressure response to topical corticosteroids. Am J Ophthalmol 1977;83:643-6.

[14] ¹⁴
Cartwright MJ, Grajewski AL, Friedberg ML, Anderson DR Richards DW. Immune-related disease and normal-tension glaucoma: A case control study. Arch. Ophthalmol 1992;110:500-2.

[15] ¹⁵
Jämsen, K. - Thyroid disease, a risk factor for optic neuropathy mimicking normal-tension glaucoma. Acta Ophthalmol Scand 1996;74:456-60.

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