Russian Medical Inquiry
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Ophthalmic manifestations of endocrine diseases

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DOI: 10.32364/2587-6821-2023-7-9-4

A.A. Gazdanova, S.A. Knyazeva, A.A. Marakhovskaya, Yu.V. Protopopova, A.A. Sedova, J.B. Rakhimov, A.F. Salmanov, S.A. Magomedova

I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation

The review provides a detailed description of ophthalmic disorders associated with the most common endocrine diseases — diabetes mellitus, hypo- and hyperthyroidism, chronic adrenal insufficiency, Cushing syndrome, and obesity. Specific characteristics of ocular disorders co-occurring with these diseases are highlighted in the article. In diabetes mellitus, there is a lesion of both the periorbital region — inflammatory processes of the eyelids and conjunctiva, xanthelasm of the eyelids, and intraocular structures — the retina, macula, lens and cornea. Ophthalmological changes in thyroid pathology are manifested by a combination of various "ocular" symptoms, the most famous of which are exophthalmos, dilation of the ocular slit, eye shine, convergence disorder. However, the first complaints of patients may be unstable diplopia, swelling of the eyelids (mainly in the morning), a feeling of "clogging", dryness, lacrimation and/or photophobia, spontaneous retrobulbar pain, pain when moving the eyes, redness of the eyelids, conjunctival injection, redness and swelling of the semilunar fold and lacrimal meat, hyperpigmentation of the eyelids — a symptom Jellineka, swelling and meniscus-like drooping of the eyelids are a symptom of a Singer. Some endocrine diseases may cause symptomatic arterial hypertension, e.g. Cushing disease (syndrome), primary hyperaldosteronism (Conn's disease), acromegaly, and pheochromocytoma. Early signs of the above diseases may include eye disorders which develop prior to other manifestations due to the onset of hypertensive retinopathy. The adequate assessment of the disorders of eyes and paraorbital tissues in patients with endocrine diseases may facilitate more accurate diagnosis and timely treatment. The publication could potentially benefit ophthalmologists, therapists, endocrinologists, pediatricians and general practitioners.

Keywords: ophthalmic manifestations, diabetes mellitus, hyperthyroidism, hypothyroidism, adrenal insufficiency, endocrine diseases.

For citation: Gazdanova A.A., Knyazeva S.A., Marakhovskaya A.A., Protopopova Yu.V., Sedova A.A., Rakhimov J.B., Salmanov A.F., Magomedova S.A. Ophthalmic manifestations of endocrine diseases. Russian Medical Inquiry. 2023;7(9):586–591 (in Russ.). DOI: 10.32364/2587-6821-2023-7-9-4.

References
1. Мунц И.В., Диреев А.О., Гусаревич О.Г. и др. Распространенность офтальмологических заболеваний в популяционной выборке старше 50 лет. Вестник офтальмологии. 2020;136(3):106–115. DOI: 10.17116/oftalma2020136031106. [Munz I.V., Direev A.O., Gusarevich O.G. et al. Prevalence of ophthalmic diseases in the population older than 50 years. Vestnik Oftalmologii. 2020;136(3):106–115 (in Russ.)]. DOI: 10.17116/oftalma2020136031106. 2. Трухан Д.И., Лебедев О.И. Изменение органа зрения при соматических заболеваниях. Терапевтический архив. 2015;87(8):132–136. DOI: 10.17116/terarkh2015878132-136. [Trukhan D.I., Lebedev O.I. Changes in the organ of vision in somatic diseases. Terapevticheskii arkhiv. 2015;87(8):132–136 (in Russ.)]. DOI: 10.17116/terarkh2015878132-136. 3. Chopra R., Chander A., Jacob J.J. The eye as a window to rare endocrine disorders. Indian J Endocrinol Metab. 2012;16(3):331–338. DOI: 10.4103/2230-8210.95659. 4. Sun H., Saeedi P., Karuranga S. et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109–119. DOI: 10.1016/j.diabres.2021.109119. 5. Cho N.H., Shaw J.E., Karuranga S. et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271–281. DOI: 10.1016/j.diabres.2018.02.023. 6. Дедов И.И., Шестакова М.В., Викулова О.К. Сахарный диабет в Российской Федерации: распространенность, заболеваемость, смертность, параметры углеводного обмена и структура сахароснижающей терапии по данным Федерального регистра сахарного диабета, статус 2017 г. Сахарный диабет. 2018;21(3):144–159. DOI: 10.14341/DM9686. [Dedov I.I., Shestakova M.V., Vikulova O.K. et al. Diabetes mellitus in Russian Federation: prevalence, morbidity, mortality, parameters of glycaemic control and structure of glucose lowering therapy according to the Federal Diabetes Register, status 2017. Diabetes mellitus. 2018;21(3):144–159 (in Russ.)]. DOI: 10.14341/DM9686. 7. Субботина Е.В., Пономарева М.Н., Дороднева Е.Ф. Воспалительные офтальмологические проявления при сахарном диабете. Университетская медицина Урала. 2019;5(2):42–43. [Subbotina E.V., Ponomareva M.N., Doroneva E.F. Inflammatory ophthalmological manifestations in diabetes mellitus. Universitetskaya medicina Urala. 2019;5(2):42–43 (in Russ.)]. 8. Nishinaka A., Naamura S., Tanaka M. et al. Excess adiponectin in eyes with progressive ocular vascular diseases. FASEB J. 2021;35(2):e21313. DOI: 10.1096/fj.202001740RR. 9. Филиппов В.М., Петрачков Д.В., Будзинская М.В., Сидамонидзе А.Л. Современные концепции патогенеза диабетической ретинопатии. Вестник офтальмологии. 2021;137(5–2):306–313. DOI: 10.17116/oftalma2021137052306. [Filippov V.M., Petrachkov D.V., Budzinskaya M.V., Sidamonidze A.L. Modern concepts of pathogenesis of diabetic retinopathy. Vestnik Oftalmologii. 2021;137(5–2):306–313 (in Russ.)]. DOI: 10.17116/oftalma2021137052306. 10. Кулыбышева В.С., Ронзина И.А., Гамидов А.А. и др. Предикторы ранних изменений сетчатки при сахарном диабете. Офтальмология. 2020;17(1):88–95. DOI: 10.18008/1816-5095-2020-1-88-95. [Kulybysheva V.S., Ronzina I.A., Gamidov A.A. et al. Predictors of Early Retinal Changes in Diabetes Mellitus. Ophthalmology in Russia. 2020;17(1):88–95 (in Russ.)]. DOI: 10.18008/1816-5095-2020-1-88-95. 11. Пшеничнов М.В., Коленко О.В., Сорокин Е.Л., Пашенцев Я.Е. Организменные факторы риска первичного формирования диабетического макулярного отека у пациентов с сахарным диабетом 2-го типа. Офтальмология. 2019;16(1):63–69. DOI: 10.18008/1816-5095-2019-1-63-69. [Pshenichnov M.V., Kolenko O.V., Sorokin E.L., Pashentcev Y.E. Intraocular Risk Factors in the Primary Formation of Diabetic Macular Edema in Patients with Diabetes Mellitus Type II. Ophthalmology in Russia. 2019;16(1):63–69 (in Russ.)]. DOI: 10.18008/1816-5095-2019-1-63-69. 12. Можеренков В.П., Прокофьева Г.Л., Усова Л.А. Глазные проявления сахарного диабета. РМЖ. Клиническая офтальмология. 2002;3(1):31–32. DOI: 10.1134/S0006297922020031. [Mozherencov V.P., Prokofyeva G.L., Usova L.A. Eye manifestations of diabetes mellitus. Сlinical ophthalmology. 2002;3(1):31–32 (in Russ.)]. DOI: 10.1134/S0006297922020031. 13. Muranov K.O., Ostrovsky M.A. Biochemistry of Eye Lens in the Norm and in Cataractogenesis. Biochemistry (Mosc). 2022;87(2):106–120. 14. Бикбов М.М., Файзрахманов Р.Р., Зайнуллин Р.М. и др. Макулярный отек как проявление диабетической ретинопатии. Сахарный диабет. 2017;20(4):263–269. DOI: 10.14341/DM8328. [Bikbov M.M., Fayzrakhmanov R.R., Zaynullin R.M. et al. Macular oedema as manifestation of diabetic retinopathy. Diabetes mellitus. 2017;20(4):263–269 (in Russ.)]. DOI: 10.14341/DM8328. 15. Бикбов М.М., Суркова В.К. Роговица и ее изменение при сахарном диабете. Обзор литературы. Сахарный диабет. 2016;19(6):479–485. DOI: 10.14341/DM7972. [Bikbov M.M., Surkova V.K. Cornea and its changes in diabetes mellitus: the revew. Diabetes mellitus. 2016;19(6):479–485 (in Russ.)]. DOI: 10.14341/DM7972. 16. Kobylianskii J., Gold W.L. Queen Anne sign. CMAJ. 2022;194(6):E219. DOI: 10.1503/cmaj.211051. 17. Wang S., Liu Y., Zheng G. Hypothyroidism as a risk factor for open angle glaucoma: A systematic review and meta-analysis. PLoS One. 2017;12(10):e0186634. DOI: 10.1371/journal.pone.0186634. 18. Свириденко Н.Ю., Шеремета М.С., Беловалова И.М., Мельниченко Г.А. Лечение болезни Грейвса при сопутствующей эндокринной офтальмопатии. Вестник офтальмологии. 2021;137(6):128–135. DOI: 10.17116/oftalma2021137061128. [Sviridenko N.Yu., Sheremeta M.S., Belovalova I.M., Melnichenko G.A. Treatment of Graves' disease in patients with thyroid eye disease. Vestnik Oftalmologii. 2021;137(6):128–135 (in Russ.)]. DOI: 10.17116/oftalma2021137061128. 19. Kamboj A., Lause M., Kumar P. Ophthalmic manifestations of endocrine disorders-endocrinology and the eye. Transl Pediatr. 2017;6(4):286–299. DOI: 10.21037/tp.2017.09.13. 20. Marino M., Ionni I., Lanzolla G. et al. Orbital diseases mimicking graves' orbitopathy: a long-standing challenge in differential diagnosis. J Endocrinol Invest. 2020;43(4):401–411. DOI: 10.1007/s40618-019-01141-3. 21. Stoyanova N.S., Konareva-Kostianeva M.I., Mitkova-Hristova V.T. Ocular Hypertension, Glaucoma or Compressive Neuropathy in Patient with Active TED. Folia Med (Plovdiv). 2020;62(2):418–423. DOI: 10.3897/folmed.62.e47689. 22. Таскина Е.С., Харинцева С.В., Харинцев В.В., Серкин Д.М. Новые возможности в диагностике эндокринной офтальмопатии (обзор литературы). Клиническая и экспериментальная тиреоидология. 2017;13(3):20–28. DOI: 10.14341/ket2017320-28. [Тaskina E.S., Harintseva S.V., Harintsev V.V., Serkin D.M. New opportunities in the diagnosis of endocrine ophthalmopathy (literature review). Clinical and experimental thyroidology. 2017;13(3):20–28 (in Russ.)]. DOI: 10.14341/ket2017320-28. 23. Киселева Т.А., Валеева Ф.В., Газизова И.И. и др. Эндокринная офтальмопатия. Практическая медицина. 2019;17(6):77–78. DOI: 10.32000/2072-1757-2019-6-77-78. [Kiseleva T.A., Valeeva F.V., Gazizova I.I. et al. Endocrine ophthalmopathy. Practical medicine. 2019;17(6):77–78 (in Russ.)]. DOI: 10.32000/2072-1757-2019-6-77-78. 24. Никонова Л.В., Тишковский С.В., Гадомская В.И. и др. Эндокринная офтальмопатия: этиология, патогенез, клиника, диагностика. Журнал Гродненского государственного медицинского университета. 2018;16(1):69–76. DOI: 10.25298/2221-8785-2018-16-1-69-76. [Nikonova L.V., Tishkovsky S.V., Gadomskaya V.I. et al. Endocrine ophthalmopathy: etiology, pathogenesis, clinic, diagnostics. Journal of the Grodno state medical University. 2018;16(1):69–76 (in Russ.)]. DOI: 10.25298/2221-8785-2018-16-1-69-76. 25. Plummer C.E., Specht A., Gelatt K.N. Ocular manifestations of endocrine disease. Compend Contin Educ Vet. 2007;29(12):733–743. PMID: 18225637. 26. Еремкина А.К., Ковалева Е.В. Гипопаратиреоз: этиология, клиническая картина, современные методы диагностики и лечения. Альманах клинической медицины. 2016;44(4):477–492. DOI: 10.18786/2072-0505-2016-44-4-477-492. [Eremkina A.K., Kovaleva E.V. Hypoparathyroidism: etiology, clinical manifestation, current diagnostics and treatment. Almanac of Clinical Medicine. 2016;44(4):477–492 (in Russ.)]. DOI: 10.18786/2072-0505-2016-44-4-477-492. 27. Мокрышева Н.Г., Липатов Д.В., Добрева Е.А., Бибик Е.Е. Особенности поражения глаз при первичном гиперпаратиреозе. Ожирение и метаболизм. 2019;16(1):3–6. DOI: 10.14341/omet9787. [Mokrysheva N.G., Lipatov D.V., Dobreva E.A., Bibik E.E. Features of the eye pathology in primary hyperparathyroidism. Obesity and metabolism. 2019;16(1):3–6 (in Russ.)]. DOI: 10.14341/omet9787. 28. Бирюкова Е.В., Ганенкова Е.С., Лованова М.Д. Хроническая надпочечниковая недостаточность в практике клинициста. Consilium Medicum. 2019;21(4):103–108. DOI: 10.26442/20751753.2019.4.190311. [Biryukova E.V., Ganenkova E.S., Lovanova M.D. Chronic adrenal insufficiency in clinical practice. Consilium Medicum. 2019;21(4):103-108 (in Russ.)]. DOI: 10.26442/20751753.2019.4.190311. 29. Hahner S., Spinnler C., Fassnacht M. et al. High incidence of adrenal crisis in educated patients with chronic adrenal insufficiency: a prospective study. J Clin Endocrinol Metab. 2015;100(2):407–416. DOI: 10.1210/jc.2014-3191. 30. Brown A.L. Ocular findings in Addison's disease. Am J Ophthalmol. 1926;9(6):409–410. 31. Culp C.J., Pappas C.M., Toso M. et al. Clinical, histological and genetic findings in a donor with a clinical history of type 1 Autoimmune Polyendocrinopathy Syndrome. Am J Ophthalmol Case Rep. 2022;25:101266. DOI: 10.1016/j.ajoc.2022.101266. 32. Митрофанова Л.Б., Коновалов П.В., Рязанов П.А. и др. Первичный и вторичный гипофизит. Клинико-морфологическое исследование. Архив патологии. 2016;78(6):43–51. DOI: 10.17116/patol201678643-51. [Mitrofanova L.B., Konovalov P.V., Ryazanov P.A. et al. Primary and secondary hypophysitis: A clinicomorphological study. Arkhiv Patologii. 2016;78(6):43 51. (in Russ.)]. DOI: 10.17116/patol201678643-51. 33. Chen Y., Liu Z., Lin Z., Shi X. Eye Signs in Pituitary Disorders. Neurol India. 2019;67(4):979–982. DOI: 10.4103/0028-3886.266265. 34. Wu P.Y., Chang H.W., Chen W.L. Neurotrophic keratitis in autoimmune polyglandular syndrome type 1: a case report. BMC Ophthalmol. 2021;21(1):17. DOI: 10.1186/s12886-020-01770-w. 35. Couturier A., Brezin A.P. Ocular manifestations of autoimmune polyendocrinopathy syndrome type 1. Curr Opin Ophthalmol. 2016;27(6):505–513. DOI: 10.1097/ICU.0000000000000306. 36. Schulz L., Hammer E. Autoimmune polyglandular syndrome type II with co-manifestation of Addison's and Graves' disease in a 15-yearold boy: case report and literature review. J Pediatr Endocrinol Metab. 2020;33(4):575–578. DOI: 10.1515/jpem-2019-0506. 37. Horino T., Ogasawara M., Ichii O., Terada Y. Autoimmune polyglandular syndrome type 3 variant in rheumatoid arthritis. Rom J Intern Med. 2020;58(1):40–43. DOI: 10.2478/rjim-2019-0024. 38. Hsu Y.T., Duann J.R., Lu M.K. et al. Polyglandular autoimmune syndrome type 4 with GAD antibody and dystonia. Clin Neurol Neurosurg. 2012;114(7):1024–1026. DOI: 10.1016/j.clineuro.2012.01.051. 39. Kapoor N., Jasper S., Kalra S. Ocular manifestations of Obesity: Beyond what meets the eye. J Pak Med Assoc. 2022;72(3):574–575. DOI: 10.47391/JPMA.22-020. 40. Ng Yin Ling C., Lim S.C., Jonas J.B., Sabanayagam C. Obesity and risk of age-related eye diseases: a systematic review of prospective populationbased studies. Int J Obes (Lond). 2021;45(9):1863–1885. DOI: 10.1038/s41366-021-00829-y. 41. Rajagopal R. Weight Reduction as an Adjunctive Management Strategy for Diabetic Retinopathy. Mo Med. 2022;119(1):42–48. PMID: 36033134. 42. Cheung N., Wong T.Y. Obesity and eye diseases. Surv Ophthalmol. 2007;52(2):180–195. DOI: 10.1016/j.survophthal.2006.12.003.

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