Biomarkers in thyroid eye disease
Reviewed by Hetvi Bhatt

An ideal biomarker is sensitive, specific, easily assessable and clinically relevant. This study looked at the presence of inflammatory cytokines present in the tear film of healthy controls, thyroid patients without eye disease (non-TED) and those with thyroid eye disease (TED). Forty-two patients were recruited: 13, 11 and 18 respectively in the aforementioned groups. IL-6 and IL-10 were found to be significantly higher in the TED group compared to non-TED and controls, however there was no statistically significant difference between active and inactive TED. Interestingly, there was a negative correlation of PDGF-AA with IL-17A and IL-2 in healthy controls, IL-17F and IL-6 in non-TED and IL-4 and IL-13 in TED. The only significant difference in active TED was not biomarker related, and this was a raised IOP compared to controls. One caveat when looking at the data is that active patients with a VISA score ≥4 were on treatment, which could have an impact on their cytokine levels. Although this is an interesting study and confirms papers that have been published before, but this time in an Indian cohort, it does not address the need to find a suitable biomarker that will predict disease activity and also treatment response.

Role of biomarkers in south indian thyroid eye disease study (SITED).
Nivean PD, Shetty R, Sethu S, et al.
ORBIT
2025;44(5):489–97.