ArticleActa ophthalmologica2026
Exploring tear fluid biomarkers and the ocular surface in thyroid eye disease.
Article in Acta ophthalmologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Nanomaterial-enabled smart contact lenses: bridging sensing, therapy, and theranostics for next-generation ocular healthcare.Journal of nanobiotechnology · 2026Review
- Exploring tear fluid biomarkers and the ocular surface in thyroid eye disease.Acta ophthalmologica · 2026Article
- High-Throughput Tear Proteomics Reveals Multi-Faceted Signatures of Thyroid Eye Disease.Investigative ophthalmology & visual science · 2025Article
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Authors and funding
14 authors.
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Abstract
purposeTo examine ocular surface changes and inflammatory tear fluid biomarkers in patients with thyroid eye disease (TED).
methodsWe included 106 Graves' disease (GD) patients (36 without TED, 32 with active and 38 with inactive TED) and 106 age- and sex-matched healthy subjects for ophthalmological evaluation, including ocular surface status and Meibomian gland function. Tear fluid was analysed for 40 inflammatory biomarkers by a Luminex multiplex bead assay. The parameters were compared across subgroups.
resultsGD patients with TED had significantly higher median (min-max) Ocular Surface Disease Index (OSDI) score than GD patients without TED, with a median score of 31.4 (0-86.4) compared to 7.3 (0-45.8) (p < 0.01). Eleven of 50 patients with moderate-to-severe and sight-threatening TED had a meibum quality score above seven, compared to none of the 20 patients with mild TED (p = 0.027). Tear fluid levels of chemokine (C-C motif) ligand 2 (CCL2) were significantly (p = 0.003) higher in GD patients compared to healthy subjects. CD40 ligand (CD40L) and CCL2 were higher in GD patients with TED compared with GD patients without TED (p = 0.002 and 0.013, respectively). As a combined biomarker to distinguish between GD patients with and without TED, OSDI score together with tear fluid levels of CCL2 and CD40L produced an area under the receiver operating characteristic (ROC) curve of 0.80, with sensitivity of 0.69 at a fixed specificity of 0.80.
conclusionsOur findings demonstrate increased tear fluid levels of CD40L and CCL2 in patients with TED, indicating their potential as diagnostic biomarkers. Increased ocular discomfort in patients with TED could be related to impaired meibum quality.
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