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LA PRESION INTRAOCULAR DISMINUYE DURANTE EL TRATAMIENTO SUSTITUTIVO CON LEVOTIROxiNA EN EL HIPOTIROIDISMO CLINICO
Intraocular pressure decreases during levothyroxine replacement therapy for overt hypothyroidism
F. Almodóvar, F. Muñoz, HF. Escobar-Morreale, G. Rebolleda, C. Varela
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    "titulo" => "LA PRESION INTRAOCULAR DISMINUYE DURANTE EL TRATAMIENTO SUSTITUTIVO CON LEVOTIROxiNA EN EL HIPOTIROIDISMO CLINICO"
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    "textoCompleto" => "<p class="elsevierStylePara"> Hypothyroidism has been proposed to play a role in the development of primary open-angle glaucoma &#40;POAG&#41;&#46; In 1965&#44; McLenachan and Davies<span class="elsevierStyleSup">1</span> prospectively compared 100 patients diagnosed with POAG and 100 patients diagnosed with closed-angle glaucoma&#44; and&#44; based on the results of a <span class="elsevierStyleSup">131</span>I thyroid uptake&#44; found thyroid hypofunction in 45&#37; of POAG patients&#44; as compared to 13&#37; of the patients with closed-angle glaucoma&#46; </p><p class="elsevierStylePara"> The association between hypothyroidism and POAG have been also supported by later studies&#44; in which a 23&#46;4&#37; prevalence of hypothyroidism&#44; as diagnosed by an increased plasma TSH concentration&#44; was found in patients with POAG<span class="elsevierStyleSup">2</span>&#46; Therefore&#44; hypothyroidism has been considered as a risk factor for POAG<span class="elsevierStyleSup">3&#44;4</span>&#46; The pathophysiologic link between hypothyroidism and POAG is also supported by the recent finding of an increased intraocular pressure &#40;IOP&#41;&#44; in patients with subclinical hypothyroidism&#44; which was decreased and even normalized after thyroid replacement therapy<span class="elsevierStyleSup">5</span>&#46; However&#44; in the latter study none of the patients matched criteria for clinically significant POAG<span class="elsevierStyleSup">5</span>&#44; a result that might have been influenced by the lack of overt hypothyroidism in these subjects&#46; </p><p class="elsevierStylePara"> Finaly&#44; autoimmune diseases have been suggested to increase the risk for POAG<span class="elsevierStyleSup">6</span>&#44; and POAG could not be related to thyroid function abnormalities&#44; but to its autoimmune <br></br> origin&#46; </p><p class="elsevierStylePara"> In the present survey we have studied the IOP and the prevalence of POAG in a group of patients with overt hypothyroidism&#44; focusing on the role of autoimmunity&#44; and on the influence of levothyroxine replacement therapy&#44; on the changes in IOP&#46; </p><p class="elsevierStylePara"><span class="elsevierStyleBold">SUBJECTS AND METHODS</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Subjets</span></p><p class="elsevierStylePara"> Eighteen patients with overt hypothyroidism&#44; 3 men and 15 women&#44; age &#40;mean &#177; SEM&#41; 52 &#177; 6 years&#44; range 20-80&#44; were selected for the study&#46; Patients were divided in two groups according to the etiology of the hypothyroidism&#46; Group 1 included 7 patients with previous thyroid ablation because of differentiated thyroid carcinoma&#46; These patients were studied 1 month after thyroid hormone withdrawal&#44; which was routinely scheduled for a whole body <span class="elsevierStyleSup">131</span>I scan&#46; Group 2 included 11 consecutive patients with overt primary autoimmune hypothyroidism&#46; In this group&#44; the time of duration of hypothiroidism prior to diagnosis was estimated from their clinical records&#46; </p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods</span></p><p class="elsevierStylePara"> At baseline&#44; serum free T4 &#40;FT4&#41; and TSH concentrations&#44; and microsomal &#40;MSA&#41; and thyroglobulin &#40;TGA&#41; antibodies were measured in all the patients&#46; </p><p class="elsevierStylePara"> All patients underwent a complete ocular examination&#46; Intraocular pressure was measured with a Goldmann tonometer&#46; Each eye was explored separately&#44; the right eye being examined first&#44; the procedure was repeated 3 times and the mean values of IOP &#40;MIOP&#41; measurement for each eye was calculated&#46; Visual fields and ophthalmoscopic exams were also performed in every patient to disclose visual field defects or optic nerve damage&#46; Primary open-angle glaucoma was defined by a IOP &#62; 21 mmHg in any eye&#44; together with decreased visual sensitivity or optic nerve defects&#46; Patients showing closed-angle glaucoma&#44; pseudoexfoliation&#44; pigment dispersion or secondary open-angle glaucoma were excluded from the study&#46; </p><p class="elsevierStylePara"> Thyroid function tests and ocular examination were repeated after 3 months of levothyroxine replacement therapy&#46; The MIOP determination&#44; and the visual field and ophthalmoscopic exams were performed by the same observer at baseline and month 3&#46; </p><p class="elsevierStylePara"><span class="elsevierStyleBold">Assays</span></p><p class="elsevierStylePara"> Serum FT4 concentration was measured by radioimmunoassay &#40;Biocode biotechnology&#44; Sclessin&#44; Belgium&#41; with a normal range of 0&#46;8-2&#46;2 ng&#47;dl&#46; Serum TSH levels were performed by immunoradiometric assay &#40;Count&#44; Llambeis&#44; United Kingdom&#41; with a normal range of 0&#46;31-5&#46;56 &#181; U&#47;ml&#46; The serum titers of MSA and TGA were determined by agglutination assay &#40;Serodia&#44; Fujirato-In&#44; Tokyo&#44; Japan&#41; with a normal range of 1 &#40;logaritmic transformation&#41;&#46; </p><p class="elsevierStylePara"><span class="elsevierStyleBold">Statistical Analysis</span></p><p class="elsevierStylePara"> The results are expressed as mean &#177; SEM in the text and table 1&#46; The comparison between Groups were made by unpaired t test&#44; and the evolution of MIOP before and during levothyroxine replacement therapy was evaluated by paired t test&#46; The relationships between IOPM and other clinical or biochemical variables &#40;visual acuity&#41; were analyzed by Pearson&#39;s correlation analysis&#46; The titers of microsomal and thyroglobulin autoantibodies underwent to logarithmic transformation before correlation analysis&#46; </p><p class="elsevierStylePara"><span class="elsevierStyleBold">RESULTS</span></p><p class="elsevierStylePara"> Primary open-angle glaucoma was not present in any patient&#44; either during overt hypothyroidism&#44; or after replacement therapy with oral levothyroxine&#46; As expected&#44; serum FT4 levels were low&#44; and serum TSH concentrations were elevated&#44; at baseline &#40;table 1&#41;&#46; In Group 1 the dose of levothyroxine was titrated to obtain normal serum FT4 levels together with suppressed TSH values&#44; in order to avoid stimulation of tumor growth by the latter &#40;table 1&#41;&#46; In Group 2&#44; in which the estimated duration of hypothyroidism was 14 &#177; 4 months&#44; the dose of levothyroxine was adjusted to maintain normal serum FT4 and TSH concentrations &#40;table 1&#41;&#46; As expected&#44; serum FT4 was higher&#44; and serum TSH was lower&#44; in Group 1 as compared to Group 2 &#40;table 1&#41;&#46; </p><p class="elsevierStylePara"><img src="1621.GIF" width="476" height="114"></img></p><p class="elsevierStylePara"> At baseline&#44; the MIOP was similar in both groups&#46; When considering the 18 studied patients together&#44; the MIOP decreased after replacement therapy &#40;fig&#46; 1&#41;&#46; Despite the differences in the FT4 and TSH values reached after 3 months of replacement therapy among the groups of patients&#44; the MIOP decreased to a similar extent in both groups &#40;table 1&#41;&#46; When studying patients individually&#44; 2 patients presented increased IOP values &#40;&#62; 21 mmHg&#41; in both eyes&#44; and 2 patients presented increased IOP in 1 eye&#44; at diagnosis&#46; These increased IOP values decreased below 21 mmHg during replacement therapy in all these patients&#46; </p><p class="elsevierStylePara"><img src="163F1.GIF" width="229" height="281"></img></p><p class="elsevierStylePara"> Finally&#44; the MIOP showed no significant correlation with the logarithmic of the titers of microsomal &#40;r &#61; 0&#46;26&#44; nonsignificant&#41; or thyroglobulin &#40;r &#61; 0&#46;31&#44; nonsignificant&#41; antibodies in Group 2&#46; No correlation was detected between the MIOP and the estimated duration of hypothyroidism &#40;r &#61; 0&#46;25&#44; nonsignificant&#41;&#46; </p><p class="elsevierStylePara"><span class="elsevierStyleBold">DISCUSSION</span></p><p class="elsevierStylePara"> Our results demonstrate that MIOP decreases after treatment of overt hypothyroidism with levothyroxine replacement therapy&#46; These data are in agreement with the findings of a reversible increase in IOP in patients with subclinical hypothyroidism<span class="elsevierStyleSup">5</span>&#46; However&#44; none of the patients in our series presented POAG during overt hypothyroidism&#44; as occurred in the patients with subclinical hypothyroidism described by Centanni et al<span class="elsevierStyleSup">5</span>&#46; </p><p class="elsevierStylePara"> The association between hypothyroidism and POAG is&#44; at least&#44; controversial<span class="elsevierStyleSup">7</span>&#46; An increased prevalence of thyroid dysfunction has been reported in patients with POAG<span class="elsevierStyleSup">1&#44;2</span>&#44; and therefore hypothyroidism has been considered as a risk factor for POAG<span class="elsevierStyleSup">3&#44;4</span>&#46; However&#44; the methods for evaluating thyroid dysfunction in the study of McLenachan and Davies<span class="elsevierStyleSup">1</span> had low sensitivity and specificity&#44; and the prevalence of newly diagnosed hypothyroidism in the study of Smith et al<span class="elsevierStyleSup">2</span> was not different in patients with POAG as compared to the control group&#46; Thus&#44; the increased prevalence of hypothyroidism in patients with POAG found in this study was related to a significant number of patients previously diagnosed of hypothyroidism&#44; who were under replacement therapy<span class="elsevierStyleSup">2</span>&#44; casting doubt upon the pathophysiologic link between thyroid hypofunction and the development of glaucoma in their series&#46; In a recent study&#44; Gillow et al have found a prevalence of hypothyroidism similar to that of the general population in a large series of POAG patients attending a specialist glaucoma clinic<span class="elsevierStyleSup">7</span>&#46; Moreover&#44; the high prevalence of POAG in patients with hypothyroidism reported by Smith et al in a previous study<span class="elsevierStyleSup">8</span> was mainly based on tonography and tonometry measurements&#44; lacking loss of visual acuity or optic nerve damage as a requirement for the definition of POAG&#46; </p><p class="elsevierStylePara"> Taken together with the results of Centanni et al<span class="elsevierStyleSup">5</span> in subclinical hypothyroidism&#44; our present results in patients with overt primary hypothyroidism suggest that&#44; in oposition to what was previously believed<span class="elsevierStyleSup">3&#44;4</span>&#44; clinically significant POAG is a rare complication of thyroid hypofunction&#44; not warranting IOP measurement in otherwise asymptomatic hypothyroid patients&#46; Moreover&#44; as patients with increased IOP in our study&#44; and in the study of Centanni et al<span class="elsevierStyleSup">5</span>&#44; did not present full POAG criteria&#44; the increase in IOP in hypothyroid patients&#44; and the decrease in IOP during levothyroxine replacement therapy&#44; suggests that thyroid hormones are involved in the physiologic control of IOP&#46; The finding of similar MIOP after short and long standing hypothyroidism&#44; along with a lack of correlation between the estimated duration of thyroid hypofunction and the MIOP in group 2&#44; also suggests that changes in the latter are related to a decrease in thyroid hormone levels&#46; </p><p class="elsevierStylePara"> Finally&#44; our data do not support the previous hypothesis of an autoimmune origin of POAG<span class="elsevierStyleSup">6</span>&#44; as no difference in MIOP was found among the groups of patients with autoimmune and non-autoimmune hypothyroidism&#46; </p><p class="elsevierStylePara"> In conclusion&#44; replacement therapy with levothyroxine for overt primary hypothyroidism results in a decrease in MIOP&#46; However&#44; only 4 patients had mildly increased IOP when hypothyroid&#44; and none of them presented POAG&#46; Therefore&#44; our data do not support a primary role of thyroid hypofunction in the development of POAG&#44; although it is possible that&#44; in patients with previous abnormalities in the regulation of IOP&#44; hypothyroidism might contribute to the development of POAG&#46; </p>"
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        "resumen" => "<span class="elsevierStyleBold">Objetivo&#58;</span> Analizar la influencia del hipotiroidismo primario cl&#237;nico sobre la presi&#243;n intraocular &#40;PIO&#41;&#46; <br/> <span class="elsevierStyleBold">Plan&#58;</span> Siete pacientes con hipotiroidismo primario no autoinmune &#40;grupo I&#41; y 11 pacientes con hipotiroidismo primario autoinmune &#40;grupo 2&#41; fueron evaluados antes y 3 meses despu&#233;s del tratamiento sustitutivo con levotiroxina&#46; <br/> <span class="elsevierStyleBold">Sujetos y M&#233;todos&#58;</span> Todos los pacientes fueron sometidos a una exploraci&#243;n visual completa incluyendo campos visuales y medidas seriadas de PIO con un ton&#243;metro de Goldmann&#44; Se midieron T4 libre y tirotropina s&#233;ricas&#44; y se determinaron los t&#237;tulos de anticuerpos microsomales y de tiroglobulina&#44; basales y despu&#233;s de corregir el hipotiroidismo con levotiroxina&#46; <span class="elsevierStyleBold">Resultados&#58;</span> La PIO media &#40;PIOM&#41; disminuy&#243; despu&#233;s de 3 meses de tratamiento sustitutivo con respeto a la situaci&#243;n basal de ambos grupos de pacientes hipotiroides &#40;media &#177; EEM&#44; grupo I&#58; basal 19&#44;0 &#177; 0&#44;6 mmHg&#44; despu&#233;s del tratamiento 17&#44;1 &#177; 0&#44;6 mmHg&#59; p &#60; 0&#44;05&#59; grupo 2&#58; basal 17&#44;8 &#177; 0&#44;7&#44; despu&#233;s del tratamiento 15&#44;5 &#177; 0&#44;8&#59; p &#60; 0&#44;05&#41;&#46; No hubo diferencias en la PIOM entre los grupos de pacientes&#46; Dos pacientes presentaron PIO &#62; 21 mmHg en ambos ojos&#44; y 2 pacientes tuvieron PIO &#62; 21 mmHg durante la administraci&#243;n de levotiroxina&#46; Ninguno de los pacientes present&#243; disminuci&#243;n de la agudeza visual ni da&#241;o en el nervio &#243;ptico&#44; y as&#237;&#44; ning&#250;n paciente fue diagnosticado con glaucoma primario de &#225;ngulo abierto cl&#237;nicamente significativo &#40;GPAA&#41;&#46; La PIOM no demostr&#243; ninguna correlaci&#243;n con la duraci&#243;n estimada del hipotiroidismo autoinmune&#44; ni con los t&#237;tulos de autoanticuerpos tiroideos&#46; <br/> <span class="elsevierStyleBold">Conclusiones&#58;</span> La presi&#243;n intraocular disminuye durante el tratamiento con levotiroxina en pacientes con hipotiroidismo cl&#237;nico&#44; independientemente de la etiolog&#237;a y de la duraci&#243;n de la hipofunci&#243;n tiroidea&#46; A pesar del incremento en la PIO en algunos de estos pacientes&#44; no se hall&#243; con frecuencia&#44; un GPAA cl&#237;nico&#44; lo que sugiere que las hormonas tiroideas pueden estar implicadas en la regulaci&#243;n normal de la PIO"
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        "resumen" => "<span class="elsevierStyleBold">Objective&#58;</span> To analyze the influence of overt primary hypothyroidism on intraocular pressure &#40;IOP&#41;&#46; <br/> <span class="elsevierStyleBold">Design&#58;</span> Seven patients with non-autoimmune primary hypothyroidism &#40;Group 1&#41; and 11 patients with autoimmune primary hypothyroidism &#40;Group 2&#41; were evaluated before and 3 months after replacement therapy with levothyroxine&#46; <br/> <span class="elsevierStyleBold">Subjects and methods&#58;</span> All patients underwent a complete ocular examination including visual fields and serial measurements of IOP with a Goldmann tonometer&#46; Measurement of serum free T4 and thyrotropin concentrations&#44; as well as determinations of the serum titers of microsomal and thyroglobulin autoantibodies&#44; were performed at baseline and after correction of hypothyroidism with levothyroxine therapy&#46; <br/> <span class="elsevierStyleBold">Results&#58;</span> The mean IOP &#40;MIOP&#41; decreased after 3 months of replacement therapy with respect to baseline in both groups of hypothyroid patients &#40;mean &#177; SEM&#44; Group 1&#58; baseline 19&#46;0 &#177; 0&#46;6 mmHg&#44; after treatment 17&#46;1 &#177; 0&#46;6 mm Hg&#44; p &#60; 0&#46;05&#59; Group 2&#58; baseline 17&#46;8 &#177; 0&#46;7&#44; after treatment 15&#46;5 &#177; 0&#46;8&#44; p &#60; 0&#46;05&#41;&#46; There were no differences in the MIOP among the groups of patients&#46; Two patients showed IOP &#62; 21 mmHg in both eyes&#44; and 2 patients had IOP &#62; 21 mmHg in one eye&#46; In all the patients&#44; IOP decreased below 21 mmHg during levothyroxine administration&#46; None of the patients presented decreased visual acuity or optic nerve damage&#44; and thus no patient was diagnosed with clinically significant primary open-angle glaucoma &#40;POAG&#41;&#46; The MIOP showed no correlation with the estimated duration of autoimmune hypothyroidism&#44; or with the titers of thyroid autoantibodies&#46; <br/> <span class="elsevierStyleBold">Conclusions&#58;</span> Intraocular pressure decreases during replacement therapy with levothyroxine in patients with overt hypothyroidism&#44; independently of the etiology and the duration of thyroid hypofunction&#46; Despite the increase in IOP in some of these patients&#44; clinical POAG is not a frequent finding&#44; suggesting that thyroid hormones might be involved in the normal regulation of IOP&#46;"
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                          "etal" => false
                          "autores" => array:2 [
                            0 => "McLenachan J"
                            1 => "Davies DM&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Br J Ophthalmol"
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                        "paginaInicial" => "441"
                        "paginaFinal" => "449"
                        "link" => array:1 [
                          0 => array:2 [
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                0 => array:2 [
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                    0 => array:3 [
                      "titulo" => "An association between hypothyroidism and primary open-angle glaucoma&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Smith KD"
                            1 => "Arthurs BP"
                            2 => "Saheb N&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ophthalmology"
                        "fecha" => "1993"
                        "volumen" => "100"
                        "paginaInicial" => "1580"
                        "paginaFinal" => "1584"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8414419"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Risk factors for the development of glaucomatous visual field loss in ocular hypertension&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Quiglay HA"
                            1 => "Enger C"
                            2 => "Katz J"
                            3 => "Sommer A"
                            4 => "Scott R"
                            5 => "Gilbert D&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Ophthalmol"
                        "fecha" => "1992"
                        "volumen" => "112"
                        "paginaInicial" => "644"
                        "paginaFinal" => "649"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8185522"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Diabetes&#44; intraocular pressure and primary open-angle in the Baltimore eye survey&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Tielsch JM"
                            1 => "Katz J"
                            2 => "Quigley HA"
                            3 => "Javitt JC"
                            4 => "Sommer A&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ophthalmology"
                        "fecha" => "1995"
                        "volumen" => "102"
                        "paginaInicial" => "48"
                        "paginaFinal" => "53"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7831041"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Reversible increase of intraocular pressure in subclinical hypothyroid patients&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Centanni M"
                            1 => "Cesareo R"
                            2 => "Verallo O"
                            3 => "Brinelli M"
                            4 => "Cannettieri G"
                            5 => "Viceconti N et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Endocrinol"
                        "fecha" => "1997"
                        "volumen" => "136"
                        "paginaInicial" => "595"
                        "paginaFinal" => "598"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9225722"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Immune-related disease and normal-tension glaucoma&#46; A case-control study&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Cartwright MJ"
                            1 => "Grajewski AL"
                            2 => "Friedberg ML"
                            3 => "Anderson DR"
                            4 => "Richards DW&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Ophthalmol"
                        "fecha" => "1992"
                        "volumen" => "110"
                        "paginaInicial" => "500"
                        "paginaFinal" => "502"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1562256"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "referenciaCompleta" => "Primary open angle glaucoma and hypothyroidism: chance or true association? Eye 1997; 11: 113-114"
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Gillow J"
                            1 => "Shah P"
                            2 => "O&#39;Neill EC&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "An ocular dynamic study supporting the hypothesis that hypothyroidism is a treatable cause of secondary open-angle glaucoma&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Smith KD"
                            1 => "Tevaaerwerk GJ"
                            2 => "Allen LH&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Ophthalmol"
                        "fecha" => "1992"
                        "volumen" => "27"
                        "paginaInicial" => "341"
                        "paginaFinal" => "344"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1490244"
                            "web" => "Medline"
                          ]
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                  ]
                ]
              ]
            ]
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