Ischemia of the Eye on the Background of Primary Hypothyroidism and Primary Thyrotoxicosis

Abstract

Purpose: to study the features of the blood filling of the eye in patients with primary untreated hypothyroidism and primary untreated thyrotoxicosis by plethysmography. Materials and methods. The material of the study was the results of a comprehensive examination of 43 patients (86 eyes): 23 people (46 eyes) with primary untreated hypothyroidism and 20 people (40 eyes) with primary untreated hyperthyroidism. The ocular blood flow was assessed by ophthalmoplethysmography. Results. The obtained plethysmography data confirm that even in the absence of endocrine ophthalmopathy in patients with primary untreated hypothyroidism and primary untreated thyrotoxicosis, deep hemodynamic disturbances in the major vessels of the eye develop leading to ischemia of its anterior and posterior parts, which can lead to hydrodynamic disturbances in the eye, sensitivity of the visual analyzer to ischemia and hypoxia and to promote the development of secondary optic neuropathy. In this study, a significant reduction of 30–40 % from the norm of volume and consumption indicators of the blood filling of the eye with impaired placement of blood in the choriocapillaries, reduced elasticity of the choroidal vessel wall was detected, which can not but trigger the development of various pathological processes. For example, ischemia of the ciliary body and the trabecular meshwork, the presence of thyroid receptors on endothelial and smooth muscle cells of choroidal and orbital vessels, can lead to hydrodynamic disturbances, and ischemia of the optic nerve, which arises due to violation peripapillary flow having choroidal source of blood supply, can result in an optical neuropathy. In this aspect, thyroid disease is associated with an increased risk of developing glaucoma, endocrine ophthalmopathy. The conclusion. Despite the constant expansion of various innovative dopplerographic systems, plethysmography — as a method of examining the blood filling of the eye, remains in demand, reliable and highly informative. In patients with uncompensated thyroid dysfunctions, a violation of the blood supply to the anterior segment of the eye is observed, which can cause a low effect of antihypertensive monotherapy in the treatment of glaucoma.