Abstract：
OBJECTIVE: Although I-131 is relatively safe, there is limited focus on probable eye-related side effects after radioactive iodine (RAI) therapy. Thus, we aimed to provide evidence for the adverse outcomes of I-131, exclusively in patients with thyroid cancer.
METHODS: A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was designed to examine the ocular complications of RAI therapy. Databases including PubMed, Scopus, and Web of Science were searched until October 2023 with specific thyroid neoplasms, ophthalmology and iodine terms. After thorough screening and review, relevant data were extracted.
RESULTS: The database search yielded 3434 articles, which resulted in the final 28 eligible studies. These studies investigated ophthalmic symptoms following RAI therapy, classifying them as obstructive diseases (for example, nasolacrimal duct obstruction; median incidence rate: 6.8%), inflammatory symptoms (median incidence rate: 13%), and cataracts (median incidence rate: 2.5 and 5%). The most common time interval between RAI therapy and the onset of symptoms was within the first 12 months and then declined in the preceding years. A strong positive correlation was observed between higher I-131 doses of more than 100 to 150 mCi (3.7-5.55 GBq) and the risk of symptom development. Ages older than 45 also showed a significant association with nasolacrimal duct obstruction.
CONCLUSIONS: The risk of ophthalmic complications is associated with various factors, including the administration of high I-131 doses, age of more than 45 years, and time to event within the first 12 months. Considering these conditions may help enhance patient care and prevent adverse outcomes that may limit patients\' quality of life.
METHODS: A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was designed to examine the ocular complications of RAI therapy. Databases including PubMed, Scopus, and Web of Science were searched until October 2023 with specific thyroid neoplasms, ophthalmology and iodine terms. After thorough screening and review, relevant data were extracted.
RESULTS: The database search yielded 3434 articles, which resulted in the final 28 eligible studies. These studies investigated ophthalmic symptoms following RAI therapy, classifying them as obstructive diseases (for example, nasolacrimal duct obstruction; median incidence rate: 6.8%), inflammatory symptoms (median incidence rate: 13%), and cataracts (median incidence rate: 2.5 and 5%). The most common time interval between RAI therapy and the onset of symptoms was within the first 12 months and then declined in the preceding years. A strong positive correlation was observed between higher I-131 doses of more than 100 to 150 mCi (3.7-5.55 GBq) and the risk of symptom development. Ages older than 45 also showed a significant association with nasolacrimal duct obstruction.
CONCLUSIONS: The risk of ophthalmic complications is associated with various factors, including the administration of high I-131 doses, age of more than 45 years, and time to event within the first 12 months. Considering these conditions may help enhance patient care and prevent adverse outcomes that may limit patients\' quality of life.
摘要：
目标：虽然I-131相对安全，对放射性碘(RAI)治疗后可能的眼部相关副作用的关注有限.因此，我们旨在为I-131的不良结局提供证据,仅在甲状腺癌患者中.
方法：一项基于PRISMA指南的系统评价旨在检查RAI治疗的眼部并发症。包括PubMed在内的数据库,直到2023年10月，Scopus和WebofScience都使用特定的MeSH术语进行了搜索。经过彻底的筛查和审查，提取相关数据。
结果：数据库搜索产生了3,434篇文章，这导致了最后28项符合条件的研究。这些研究调查了RAI治疗后的眼科症状，将它们分类为阻塞性疾病(例如，鼻泪管阻塞[NLDO；中位发病率：6.8%]），炎症症状（中位发病率：13%），和白内障（中位发病率：2.5％和5％）。RAI治疗和症状发作之间最常见的时间间隔是在前12个月内，然后在前几年下降。在超过100-150mCi（3.7-5.55GBq）的较高I-131剂量与症状发展的风险之间观察到很强的正相关。45岁以上的年龄也显示出与NLDO的显著关联。
结论：眼科并发症的风险与各种因素有关，包括高剂量的I-131，年龄超过45岁，以及前12个月内的事件时间。考虑到这些情况可能有助于加强患者护理，防止可能限制患者生活质量的不良后果。
方法：一项基于PRISMA指南的系统评价旨在检查RAI治疗的眼部并发症。包括PubMed在内的数据库,直到2023年10月，Scopus和WebofScience都使用特定的MeSH术语进行了搜索。经过彻底的筛查和审查，提取相关数据。
结果：数据库搜索产生了3,434篇文章，这导致了最后28项符合条件的研究。这些研究调查了RAI治疗后的眼科症状，将它们分类为阻塞性疾病(例如，鼻泪管阻塞[NLDO；中位发病率：6.8%]），炎症症状（中位发病率：13%），和白内障（中位发病率：2.5％和5％）。RAI治疗和症状发作之间最常见的时间间隔是在前12个月内，然后在前几年下降。在超过100-150mCi（3.7-5.55GBq）的较高I-131剂量与症状发展的风险之间观察到很强的正相关。45岁以上的年龄也显示出与NLDO的显著关联。
结论：眼科并发症的风险与各种因素有关，包括高剂量的I-131，年龄超过45岁，以及前12个月内的事件时间。考虑到这些情况可能有助于加强患者护理，防止可能限制患者生活质量的不良后果。
