Shorter NIBUT, Higher MG Dropout Ratio Found in DED Patients with Thyroid Dysfunction

A combination of NIBUT and MG dropout assessment could potentially serve as a predictive biomarker for thyroid disorders in dry eye patients, new research suggests. Its authors believe the association between these biomarkers and thyroid dysfunction “highlight the potential role of evaporative dry eye mechanisms in thyroid-related DED pathogenesis.” These meibography images from the study show glandular changes brought on by thyroid disease. Photo: Lu Y, et al. BMC Ophthalmol. 2025;25(1):229. Click image to enlarge. Given the higher prevalence of dry eye disease (DED) in patients with thyroid disorders, researchers aimed to elucidate the clinical characteristics and associations between the two conditions in a new study published in BMC Ophthalmology. It was found that patients with thyroid disorders exhibited significant correlations between higher levels of thyroid function antibodies and increased severity of DED symptoms, specifically through shorter non-invasive break-up times (NIBUT) and higher meibomian gland (MG) dropout ratios. The retrospective cross-sectional chart review included 99 patients who had been diagnosed with DED and underwent thyroid function screening. Key diagnostic parameters such as corneal fluorescein staining, Schirmer test and MG dropout ratio were examined and correlated with patients’ thyroid function.The analysis revealed that nearly half of DED patients (47.5%) exhibited thyroid disorders; those that did generally had shorter NIBUT-first and increased MG dropout ratio. When evaluating thyroid function, the researchers found that heightened levels of two antibodies—anti-thyroid peroxidase and anti-thyroglobulin—were significantly linked to decreased NIBUT and elevated MG dropout ratios.“Although our study is based on a specialized population, this prevalence underscores the widespread relevance of thyroid disorders in DED pathogenesis,” the researchers reported in their study, adding that “these findings align with previous reports linking thyroid autoimmunity and DED severity.”Notably, a combined diagnostic index of NIBUT and MG dropout ratio achieved an area under the curve of 0.841, indicating good diagnostic performance for predicting thyroid disorders, with a sensitivity of 88.2% and specificity of 66.2%. Given that no other DED parameters showed a significant association with thyroid disorders, the researchers proposed that “the marked disparities in NIBUT and MG dropout ratios [in patients with thyroid dysfunction] highlight the potential role of evaporative dry eye mechanisms in thyroid-related DED pathogenesis.”Based on these findings, the study authors concluded that NIBUT and MG dropout assessments could have “promising diagnostic potential as a predictive biomarker for thyroid disorders in DED populations, underscoring the value of ocular surface evaluation in detecting systemic autoimmune disorders.” Click here for the journal source.  Lu Y, Wan X, Ye H, et al. Clinical characteristics of dry eye patients with thyroid disorders: a cross-sectional study. BMC Ophthalmol. 2025;25(1):229.