Selenium: Could It Be the Game-Changer for Ocular Surface and Anterior Chamber in Graves' Disease?

OBJECTIVES: To evaluate the effects of selenium supplementation on ocular surface parameters and anterior segment architecture in euthyroid Graves' disease (GD) patients without ophthalmopathy.
METHODS: This cross-sectional study included 218 consecutive euthyroid GD patients without clinical manifestations of Graves' ophthalmopathy (GO). Patients underwent comprehensive ophthalmological examination, including the Ocu-lar Surface Disease Index (OSDI) questionnaire, tear film break-up time (T-BUT), Oxford scale scoring, and Pentacam Scheimpflug imaging for anterior segment parameters assessment. Selenium intake was questioned, and based on selenium intake, participants were divided into two groups: the selenium intake group (n=106), receiving selenium supplementa-tion (100 μg twice daily for 6 months) with standard anti-thyroid therapy, and the control group (n=112), receiving only standard anti-thyroid therapy.
RESULTS: The mean age was 45.7±7.8 years (range: 30–61) in the selenium intake group (n=106; 48 females, 58 males) and 46.1±7.5 years (range: 30–60) in the control group (n=112; 52 females, 60 males), with no significant difference between groups (p=0.821 for age, p=0.904 for gender distribution). The mean duration of selenium supplementation was 11.4±4.2 months. The selenium group showed significantly better ocular surface parameters, with lower OSDI scores and higher T-BUT values compared to the control group (p<0.001 for both). Oxford staining scores were lower in the selenium group, though not statistically significant (p=0.244). Pentacam analysis revealed significantly higher anterior chamber volume (p=0.024) and central corneal thickness (p<0.001) in the selenium group, while anterior chamber depth and angle width were higher but not statistically significant (p=0.322 and p=0.276, respectively).
DISCUSSION AND CONCLUSION: Selenium supplementation is associated with better ocular surface parameters and different anterior seg-ment architecture in euthyroid GD patients without ophthalmopathy. Clinical associations observed in these cases may be related to selenium's antioxidant and anti-inflammatory properties through glutathione peroxidase and thioredoxin reductase activity, suggesting selenium as a potentially beneficial therapeutic approach for ocular surface integrity in GD.