V D Yartsev, E L Atkova, E A Ushakov, A A Trukhin, D V Yudakov, S V Grishkov, M S Sheremeta, M A Efremenko, P N Ilina
{"title":"[分化型甲状腺癌放射碘治疗后泪道引流阻塞的时间模式]。","authors":"V D Yartsev, E L Atkova, E A Ushakov, A A Trukhin, D V Yudakov, S V Grishkov, M S Sheremeta, M A Efremenko, P N Ilina","doi":"10.17116/oftalma202614202134","DOIUrl":null,"url":null,"abstract":"<p><p>Radioactive iodine (I-131) therapy for differentiated thyroid cancer is associated with a risk of delayed complications affecting radiosensitive organs. One such complication is secondary obstruction of the lacrimal drainage system caused by accumulation of I-131 in the wall of the nasolacrimal duct, leading to chronic inflammation and fibrosis. However, the precise chronological pattern of this pathology's onset remains undefined.</p><p><strong>Purpose: </strong>This study investigated the chronological patterns of lacrimal drainage obstruction following radioactive iodine therapy.</p><p><strong>Material and methods: </strong>This retrospective survey involved 375 patients who underwent a single course of radioactive iodine therapy between 2021 and 2025. The patients were stratified into five groups according to the time interval between therapy and survey: ≤6; 7-12; 13-24; 25-36; and 37-51 months. Obstruction was defined as epiphora graded 3-4 on the Munk scale. Statistical analysis included Pearson's <i>χ</i>² test, Fisher's exact test, and linear trend analysis (<i>p</i><0.05 was considered significant).</p><p><strong>Results: </strong>No cases of lacrimal drainage obstruction were identified within the first 6 months after therapy, then the frequency of complications increased progressively: 6.3% (7-12 months), 11.3% (13-24 months), and 13.6% (25-36 months), followed by a decrease to 7.5% (37-51 months). The association with time since radioactive iodine therapy was statistically significant (<i>p</i>=0.014; <i>p</i>=0.002). After 6 months, the association lost statistical significance (<i>p</i>=0.455), indicating risk stabilization. The probability of obstruction was significantly higher in men (<i>χ</i>²=5.637; <i>p</i>=0.018). The administered activity of I-131 had no statistically significant impact.</p><p><strong>Conclusion: </strong>Lacrimal drainage obstruction is a delayed complication of radioactive iodine therapy for differentiated thyroid cancer, with a peak incidence at 25-36 months after treatment. The critical screening period is 6-51 months post-therapy. Early diagnosis and timely referral to an ophthalmologist improve the effectiveness of minimally invasive interventions.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"142 2","pages":"34-39"},"PeriodicalIF":0.0000,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Chronological patterns of lacrimal drainage obstruction following radioactive iodine therapy for differentiated thyroid cancer].\",\"authors\":\"V D Yartsev, E L Atkova, E A Ushakov, A A Trukhin, D V Yudakov, S V Grishkov, M S Sheremeta, M A Efremenko, P N Ilina\",\"doi\":\"10.17116/oftalma202614202134\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Radioactive iodine (I-131) therapy for differentiated thyroid cancer is associated with a risk of delayed complications affecting radiosensitive organs. One such complication is secondary obstruction of the lacrimal drainage system caused by accumulation of I-131 in the wall of the nasolacrimal duct, leading to chronic inflammation and fibrosis. However, the precise chronological pattern of this pathology's onset remains undefined.</p><p><strong>Purpose: </strong>This study investigated the chronological patterns of lacrimal drainage obstruction following radioactive iodine therapy.</p><p><strong>Material and methods: </strong>This retrospective survey involved 375 patients who underwent a single course of radioactive iodine therapy between 2021 and 2025. The patients were stratified into five groups according to the time interval between therapy and survey: ≤6; 7-12; 13-24; 25-36; and 37-51 months. Obstruction was defined as epiphora graded 3-4 on the Munk scale. Statistical analysis included Pearson's <i>χ</i>² test, Fisher's exact test, and linear trend analysis (<i>p</i><0.05 was considered significant).</p><p><strong>Results: </strong>No cases of lacrimal drainage obstruction were identified within the first 6 months after therapy, then the frequency of complications increased progressively: 6.3% (7-12 months), 11.3% (13-24 months), and 13.6% (25-36 months), followed by a decrease to 7.5% (37-51 months). The association with time since radioactive iodine therapy was statistically significant (<i>p</i>=0.014; <i>p</i>=0.002). After 6 months, the association lost statistical significance (<i>p</i>=0.455), indicating risk stabilization. The probability of obstruction was significantly higher in men (<i>χ</i>²=5.637; <i>p</i>=0.018). The administered activity of I-131 had no statistically significant impact.</p><p><strong>Conclusion: </strong>Lacrimal drainage obstruction is a delayed complication of radioactive iodine therapy for differentiated thyroid cancer, with a peak incidence at 25-36 months after treatment. The critical screening period is 6-51 months post-therapy. Early diagnosis and timely referral to an ophthalmologist improve the effectiveness of minimally invasive interventions.</p>\",\"PeriodicalId\":23529,\"journal\":{\"name\":\"Vestnik oftalmologii\",\"volume\":\"142 2\",\"pages\":\"34-39\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2026-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vestnik oftalmologii\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.17116/oftalma202614202134\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vestnik oftalmologii","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17116/oftalma202614202134","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
[Chronological patterns of lacrimal drainage obstruction following radioactive iodine therapy for differentiated thyroid cancer].
Radioactive iodine (I-131) therapy for differentiated thyroid cancer is associated with a risk of delayed complications affecting radiosensitive organs. One such complication is secondary obstruction of the lacrimal drainage system caused by accumulation of I-131 in the wall of the nasolacrimal duct, leading to chronic inflammation and fibrosis. However, the precise chronological pattern of this pathology's onset remains undefined.
Purpose: This study investigated the chronological patterns of lacrimal drainage obstruction following radioactive iodine therapy.
Material and methods: This retrospective survey involved 375 patients who underwent a single course of radioactive iodine therapy between 2021 and 2025. The patients were stratified into five groups according to the time interval between therapy and survey: ≤6; 7-12; 13-24; 25-36; and 37-51 months. Obstruction was defined as epiphora graded 3-4 on the Munk scale. Statistical analysis included Pearson's χ² test, Fisher's exact test, and linear trend analysis (p<0.05 was considered significant).
Results: No cases of lacrimal drainage obstruction were identified within the first 6 months after therapy, then the frequency of complications increased progressively: 6.3% (7-12 months), 11.3% (13-24 months), and 13.6% (25-36 months), followed by a decrease to 7.5% (37-51 months). The association with time since radioactive iodine therapy was statistically significant (p=0.014; p=0.002). After 6 months, the association lost statistical significance (p=0.455), indicating risk stabilization. The probability of obstruction was significantly higher in men (χ²=5.637; p=0.018). The administered activity of I-131 had no statistically significant impact.
Conclusion: Lacrimal drainage obstruction is a delayed complication of radioactive iodine therapy for differentiated thyroid cancer, with a peak incidence at 25-36 months after treatment. The critical screening period is 6-51 months post-therapy. Early diagnosis and timely referral to an ophthalmologist improve the effectiveness of minimally invasive interventions.
期刊介绍：
The journal publishes materials on the diagnosis and treatment of eye diseases, hygiene of vision, prevention of ophthalmic affections, history of Russian ophthalmology, organization of ophthalmological aid to the population, as well as the problems of special equipment. Original scientific articles and surveys on urgent problems of theory and practice of Russian and foreign ophthalmology are published. The journal contains book reviews on ophthalmology, information on the activities of ophthalmologists" scientific societies, chronicle of congresses and conferences.The journal is intended for ophthalmologists and scientific workers dealing with clinical problems of diseases of the eye and physiology of vision.
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