The Effect of Intravenous Glucocorticoids on the Tearfilm in Eyes With Thyroid-associated Ophthalmopathy
- Conditions
- Thyroid-associated OphthalmopathyDry Eye Syndrome
- Interventions
- Registration Number
- NCT01579539
- Lead Sponsor
- Medical University of Vienna
- Brief Summary
Thyroid-associated ophthalmopathy (TAO), also called Graves' ophthalmopathy or thyroid eye disease, is a common orbital disease in adults. Patients with TAO, especially in its active phase, often complain about symptoms of ocular surface discomfort, including excess tearing, gritty sensation, increased sensitivity to light and foreign-body sensation, which are similar to inflammatory ocular surface disorders such as dry-eye syndrome (DES). Incomplete blink, increased proptosis and greater palpebral fissure width in TAO accelerates tear evaporation, which increases the tear fluid's osmolarity, and results in ocular surface damage. The administration of intravenous glucocorticoids can be an effective treatment for TAO.
The rationale of the present study is to assess the effect of intravenously administered glucocorticoids on the signs of DES in patients with TAO with new methods such as measurement of tear film thickness, tear film osmolarity and scattering of the tear film and well established methods for assessment of the severity of DES. Additionally, impression cytology and determination of tear cytokines/chemokines will be performed to obtain information about inflammatory processes on the ocular surface.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 18
- Men and women aged over 18 years
- Active thyroid associated ophthalmopathy with clinical activity score (CAS) of each eye more than 3 or recently experienced worsening of proptosis, lid retraction, or ocular motility disturbance.
- Normal ophthalmic findings except symptoms associated with TAO
- Scheduled for treatment with systemic glucocorticoids according to the kahaly-scheme
- Chronic inactive TAO
- Previous treatment with oral or intravenous glucocorticoids 3 months preceding the study
- Participation in a clinical trial in the 3 weeks before the screening visit
- Symptoms of a clinically relevant illness in the 3 weeks before the first study day
- Presence or history of a severe medical condition that will interfere with the study aim as judged by the clinical investigator
- Wearing of contact lenses
- Intake of dietary supplements in the 3 months preceding the study
- Topical treatment with any ophthalmic drug in the 4 weeks preceding the study except topical lubricants
- Ocular infection
- Ocular surgery in the 3 months preceding the study
- Sjögren's syndrome
- Stevens-Johnson syndrome
- Pregnancy, planned pregnancy or lactating
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Patients Methylprednisolone Patients with moderate to severe thyroid-associated ophthalmopathy Patients Esomeprazole Patients with moderate to severe thyroid-associated ophthalmopathy
- Primary Outcome Measures
Name Time Method Tear film thickness as measured with OCT 13 weeks Measurements of tear film thickness with OCT will be performed 7 or less days before start of treatment, 6 weeks after start of treatment and 12 weeks after start of treatment
- Secondary Outcome Measures
Name Time Method Break up time (BUT) 13 weeks Visual acuity 13 weeks Tear film osmolarity 13 weeks Degree of exophthalmia 13 weeks Hertel exophthalmometry
Palpebral fissure width 13 weeks OSI (Objective Scattering Index) 13 weeks Tear cytokines/chemokines 13 weeks Impression cytology 13 weeks Staining of the cornea with fluorescein 13 weeks Schirmer I test 13 weeks Subjective symptoms of dry eye syndrome 13 weeks
Trial Locations
- Locations (1)
Department of Clinical Pharmacology, Medical University of Vienna
🇦🇹Vienna, Austria