Oxidative Stress Profile in Graves’ Ophthalmopathy in Indian Patients

Purpose: To report the oxidative stress profile in patient of Graves’ ophthalmopathy and to study the effect of hormone level normalization on oxidative stress profile. Methods: All first time reporting patients with Graves’ ophthalmopathy to Department of ophthalmology CSM Medical University (erstwhile King George’s Medical University) Lucknow during the period January 2006 to December 2008 formed the cohort. Before initiating treatment a proforma directed detailed history, complete ophthalmological examination and investigations were done. Blood sample for pro/antioxidant enzyme were withdrawn for study after taking an informed consent. Patients were treated with antithyroid drugs alone to achieve a stable euthyroid status for at least 6 months following which a blood sample was again withdrawn to study the pro/anti oxidant enzyme status following treatment. Results: On normalization of thyroid status the values of reactive oxygen species decreased significantly (p<0.05) and levels of antioxidants also got corrected significantly (p<0.05). However both these values remained significantly (p<0.05) altered as compared to normal persons. Conclusion: We demonstrated that even after normalization of thyroid hormone level, the oxidative stress levels remain elevated. Moreover, activity of Superoxide Dismutase (SOD), Catalase (CAT), Glutathione reductase (GSHR), Glutathione peroxidise (GPx) showed decrease which could be attributed to altered metabolism and already prevalent deficiency of essential micronutrients like zinc, copper, mercury, and selenium in the Indian population. Hence, this gives way to the thought that the supplementation of these nutrients may have a role as an adjuvant to hormonal therapy in patients with Graves’ ophthalmopathy.