Corneal biomechanical properties in thyroid eye disease

Kaohsiung J Med Sci. 2014 Jun;30(6):299-304. doi: 10.1016/j.kjms.2014.02.015. Epub 2014 Apr 17.


The purpose of this study is to investigate the effect of thyroid eye disease (TED) on the measurement of corneal biomechanical properties and the relationship between these parameters and disease manifestations. A total of 54 eyes of 27 individuals with TED and 52 eyes of 30 healthy control participants were enrolled. Thyroid ophthalmopathy activity was defined using the VISA (vision, inflammation, strabismus, and appearance/exposure) classification for TED. The intraocular pressure (IOP) measurement with Goldmann applanation tonometer (GAT), axial length (AL), keratometry, and central corneal thickness (CCT) measurements were taken from each patient. Corneal biomechanical properties, including corneal hysteresis (CH) and corneal resistance factor (CRF) and noncontact IOP measurements, Goldmann-correlated IOP (IOPg) and corneal-compensated IOP (IOPcc) were measured with the Ocular Response Analyzer (ORA) using the standard technique. Parameters such as best corrected visual acuity, axial length, central corneal thickness, and corneal curvature were not statistically significant between the two groups (p > 0.05). IOP measured with GAT was higher in participants with TED (p < 0.001). The CH of TED patients was significantly lower than that of the control group. There was no significant difference in the corneal resistance factor between groups. However, IOPg and IOPcc were significantly higher in TED patients. CH and VISA grading of TED patients showed a negative correlation (p = 0.007). In conclusion, TED affects the corneal biomechanical properties by decreasing CH. IOP with GAT and IOPg is found to be increased in these patients. As the severity of TED increases, CH decreases in these patients.

Keywords: Corneal biomechanical properties; Corneal hysteresis; Thyroid eye disease; VISA classification.

MeSH terms

  • Adult
  • Aged
  • Biomechanical Phenomena
  • Case-Control Studies
  • Cornea / physiopathology*
  • Eye Diseases / complications*
  • Eye Diseases / physiopathology*
  • Female
  • Graves Disease / complications*
  • Graves Disease / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Thyroid Gland / pathology*
  • Young Adult