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Yildiz I, Asik Nacaroglu S, Ozturk Karabulut G, Fazil K, Altan C. Comparison of macular and optic disc vessel density in thyroid orbitopathy: a comparative octa study. Int Ophthalmol 2024; 44:178. [PMID: 38622472 DOI: 10.1007/s10792-024-03114-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 03/24/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE To determine the microvascular and structural changes in the peripapillary and macular areas observed in patients with active thyroid orbitopathy(TO) before and after steroid treatment and compare with inactive TO and the control group by optical coherence tomography angiography (OCTA). MATERIAL AND METHOD This cross-sectional study included 34 eyes of 17 active TO patients, 108 eyes of 54 inactive TO patients, and 60 eyes of 30 healthy controls. Central macular thickness (CMT), ganglion cell layer-inner plexiform layer (GCL-IPL) thickness, central choroidal thickness (CCT), retinal nerve fiber layer (RNFL) thickness, choroidal thickness in the peripapillary region, superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris vessel densities were determined by OCTA in before and after 12-week steroid treatment of active TO cases, inactive TO and control groups. RESULTS Between the three groups in macula OCTA, a statistically significant difference was observed in the inferior and nasal quadrants in SCP (all p = 0.01) and only in the temporal quadrant choriocapillaris (p = 0.005). In peripapillary OCTA, a statistically significant difference was found only in the central choriocapillaris (p = 0.03). In the comparison of the active group before and after treatment, there was a statistically significant decrease in CMT and CCT; a statistically significant increase was observed in GCL-IPL (all p < 0.01). There was a statistically significant decrease in SCP and DCP only in the central (all p < 0.01). There was a statistically significant increase was found in the lower quadrant macular SCP vessel density and mean macular DCP in post-treatment measurements (p = 0.01 and p = 0.03, respectively). Peripapillary SCP and DCP vessel density was increased after treatment (p < 0.01). CONCLUSION Active TO group had lower vessel density than inactive group and after treatment, vessel density was increased. Non-invasive quantitative analysis of retinal and optic disc perfusion using OCTA could be useful in early treatment before complications occur and monitoring patients with TO.
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Affiliation(s)
- Izlem Yildiz
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey.
| | - Senay Asik Nacaroglu
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Gamze Ozturk Karabulut
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Korhan Fazil
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
| | - Cigdem Altan
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Bereketzade Street Number:2, Beyoglu, Istanbul, Turkey
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Ceylanoglu KS, Sen EM, Karamert SS, Erdeve SS, Cetinkaya S. Optical coherence tomography angiography findings in pediatric patients with graves ophthalmopathy. Int Ophthalmol 2023; 43:3609-3614. [PMID: 37392258 DOI: 10.1007/s10792-023-02769-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/22/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE The aim of this study was to evaluate peripapillary, macular microvascular structure, and retinal nerve fiber layer (RNFL) thickness profile in children with Graves Ophthalmopathy (GO). MATERIAL AND METHODS Thirty-six eyes of 18 children with GO were prospectively compared with 40 eyes of 20-age and sex-matched controls. The severity and activity of the disease were evaluated according to the criteria of the European Group on Graves' Ophthalmopathy (EUGOGO) and Clinical Activity Score (CAS). After complete ophthalmologic and endocrinologic examination, all patients underwent optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) measurements. Retinal nerve fiber layer (RNFL) thickness, macular superficial capillary plexus (SCP), deep capillary plexus (DCP), foveal avascular zone (FAZ) area, acircularity index (AI) of the FAZ and peripapillary microvascular structure were analyzed. RESULTS The mean age was 12.1 ± 2.4 years in the GO group and 11.2 ± 2.6 years in healthy control group (p = 0.11). Duration of disease was 8.9 ± 4.2 months in the GO group. All patients in GO group had mild and inactive ophthalmopathy. In temporal inferior quadrant, RNFL thickness was significantly thinner in the GO group compared to the control group (p = 0.03). No significant difference was seen between groups both peripapillary and macular microvascular structure (all p > 0.05). CONCLUSION GO has no effect on optic nerve thickness, peripapillary and macular vascular parameters except inferior temporal RNFL in children.
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Affiliation(s)
| | - Emine Malkoc Sen
- University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - Selin Sahin Karamert
- University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynaecology, Children's Health and Disease Education and Research Hospital, Ophthalmology Department, Ankara, Turkey
| | - Senay Savas Erdeve
- University of Health Science, Dr. Sami Ulus Obstetrics and Gynaecology, Children's Health and Disease Education and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Semra Cetinkaya
- University of Health Science, Dr. Sami Ulus Obstetrics and Gynaecology, Children's Health and Disease Education and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
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KUNT Z, MADEN G, KARATAŞ ME, MART G. Optic disc, macula and ganglion cell layer measurements obtained with optical coherence tomography in patients with thyroid disorder. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1165752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose: The aim of this study was to compare retinal nerve layer thickness, central macula thickness and ganglion cell layer measurements using optical coherence tomography (OCT) between thyroid patients and age- and sex-matched healthy controls.
Materials and Methods: Eighty eyes of 80 patients in the thyroid patient group and 48 eyes of 48 patients in the control group were included in the study. After evaluating the exclusion criteria, visual acuity, anterior segment biomicroscopy, intraocular pressure, fundoscopy and spectral field optic coherence tomography (SF-OCT) imaging tests were performed on all patients included in the study. These data have been recorded. Central macular thickness (CMT), retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) measurements were evaluated by statistical methods for both groups.
Results: There was no statistically significant difference between the demographic data of the groups included in the study. IOP measurements were found to be statistically significantly higher in the patient group compared to the control group. CMT values were 258.2±16.1 µm in the patient group and 273.1±23.8 µm in the control group, and statistically significant differences were observed between the groups.
Conclusion: The findings supports that changes in the optic nerve and macula develop before vision loss in TO patients compared to the healthy control group. We can follow TO patients more objectively and reliably and make treatment planning more accurately by adding OCT, which is a noninvasive test, to our clinical practice, since structural changes develop before functional deterioration in TO patients.
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Ogmen BE, Ugurlu N, Bilginer MC, Polat SB, Genc B, Ersoy R, Cakir B. Thicknesses of the retinal layers in patients with Graves' disease with or without orbitopathy. Int Ophthalmol 2022; 42:3397-3405. [PMID: 35551579 DOI: 10.1007/s10792-022-02339-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Graves' orbitopathy (GO) is an inflammatory process that may involve the ocular surface, orbital fat, extraocular muscles, and optic nerves in patients with Graves' disease (GD). We aimed to compare thicknesses of retinal layers in patients with GD with and without GO. METHODS One hundred seven patients with GD [23 with GO (Group 1), 84 without GO (Group 2)] and eighteen volunteers (Group 3) were enrolled. The spectral-domain optical coherence tomography (SD-OCT) was used for ophthalmologic evaluation. Seven retinal layers including retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE) were assessed. The thicknesses of layers were compared in groups. RESULTS The median GCL thickness values in groups 1, 2, and 3 were 14 µm, 15 µm, and 17.5 µm, respectively (p = 0.02). The median IPL thickness was 20 µm in group 1, 21 µm in group 2, and 22 µm in group 3 (p = 0.038). The median RPE thickness values in groups 1, 2, and 3 were 16 µm, 17 µm, and 18.5 µm, respectively (p = 0.001). GCL in group 1 was thinner than in group 3 (p = 0.02), while similar in groups 2 and 3 (p = 0.06). IPL in group 1 was thinner than in group 3 (p = 0.035), while similar in groups 2 and 3 (p = 0.13). RPE in groups 1 and 2 was thinner than in group 3 (p = 0.009, p = 0.001, respectively), while it was similar in groups 1 and 2 (p = 0.93). RNLF, INL, OPL, ONL were similar in all three (p > 0.05 for each). CONCLUSION Ganglion cell layer and IPL were thinner in patients with GO than in healthy controls, while both were similar in patients without GO and healthy controls. RPE was thinner in all Graves patients than in healthy controls. Early detection of changes in retinal layers of GD may guide the physician to prevent significant vision problems.
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Affiliation(s)
- Berna Evranos Ogmen
- Faculty of Medicine, Ankara Bilkent City Hospital, Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Üniversiteler Mh., Bilkent Blv., 06800, Ankara, Turkey.
| | - Nagihan Ugurlu
- Faculty of Medicine, Ankara Bilkent City Hospital, Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Muhammet Cuneyt Bilginer
- Faculty of Medicine, Department of Endocrinology and Metabolism, Karadeniz Technical University, Trabzon, Turkey
| | - Sefika Burcak Polat
- Faculty of Medicine, Ankara Bilkent City Hospital, Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Üniversiteler Mh., Bilkent Blv., 06800, Ankara, Turkey
| | - Birgul Genc
- Health Sciences Institute, Ankara Bilkent City Hospital, Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Reyhan Ersoy
- Faculty of Medicine, Ankara Bilkent City Hospital, Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Üniversiteler Mh., Bilkent Blv., 06800, Ankara, Turkey
| | - Bekir Cakir
- Faculty of Medicine, Ankara Bilkent City Hospital, Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Üniversiteler Mh., Bilkent Blv., 06800, Ankara, Turkey
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The changes of retinal nerve fibre layer and ganglion cell layer with different severity of thyroid eye disease. Eye (Lond) 2022; 36:129-134. [PMID: 33637966 PMCID: PMC8727574 DOI: 10.1038/s41433-021-01453-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/17/2021] [Accepted: 01/29/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To evaluate the changes of retinal nerve fibre layer (RNFL) and ganglion cell layer/inner plexiform layer (GCL/IPL) with the severity of thyroid eye disease (TED). METHODS One hundred and forty-five eyes of 75 patients with TED and 70 eyes of 35 healthy controls were included. The eyes with TED were divided into mild group (35 eyes), moderate-to-severe group (42 eyes) and DON group (68 eyes). The thickness of RNFL and GCL/IPL were measured by optic coherence tomography (OCT). Clinical activity score (CAS), best corrected visual acuity (BCVA), intraocular pressure (IOP), proptosis and mean deviation (MD) by Humphrey perimetry were assessed. RESULTS The CAS had significant difference between the three groups (p < 0.001). The proptosis and IOP were significantly higher in DON group and moderate-to-severe group than mild group (p < 0.05). The MD and BCVA were significantly worse in DON group compared with mild group and moderate-to-severe group (p < 0.001). The mean GCL/IPL thickness was thinnest in DON group (p < 0.001). The mean RNFL thickness had significant difference between moderate-to-severe group and DON group (p = 0.036). The mean GCL/IPL thickness had a significant correlation with MD (r = 0.449, p < 0.001) and VA (r = -0.388, p < 0.001), whereas the mean RNFL thickness had no significant correlation with MD (p = 0.082) or VA (p = 0.226). CONCLUSIONS Subclinical optic neuropathy might progress in the patients with moderate-to-severe TED. OCT measurements of GCL/IPL and RNFL are useful to detect the early changes of optic nerve. The thinning of GCL/IPL might be a strong suggestion for closer vision follow-up and earlier decompression surgery.
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Rajabi MT, Ojani M, Riazi Esfahani H, Tabatabaei SZ, Rajabi MB, Hosseini SS. Correlation of peripapillary nerve fiber layer thickness with visual outcomes after decompression surgery in subclinical and clinical thyroid-related compressive optic neuropathy. J Curr Ophthalmol 2018; 31:86-91. [PMID: 30899852 PMCID: PMC6407141 DOI: 10.1016/j.joco.2018.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 10/08/2018] [Accepted: 11/05/2018] [Indexed: 12/03/2022] Open
Abstract
Purpose To assess the correlation of peripapillary retinal nerve fiber layer (PRNFL) thickness with visual recovery in compressive optic neuropathy (CON) in patients with thyroid eye disease (TED). Methods Twenty-three eyes of 13 consecutive patients with TED-related CON were prospectively recruited. Assessment of PRNFL by means of spectral domain optical coherence tomography (SD-OCT), visual field (VF) parameters, color vision, and visual acuity in logMAR were compared before and 6 months after decompression surgery in the operated eye for each patient, which in ten cases included both eyes. Decompression surgery was performed as medial and inferior wall decompression sparing the orbital strut by the same surgeon. Results There was a significant correlation between the preoperative PRNFL average thickness and postoperative improvement in visual acuity among all patients (P = 0.048). This correlation was found to be significant in clinically non-edematous optic neuropathy cases (P = 0.023) but not in edematous optic neuropathy (P = 0.23). There was significant correlation between PRNFL thickness and improvement of postoperative mean deviation (MD) and pattern standard deviation (PSD) parameters in VF studies and in color vision scores (P = 0.005, P = 0.02, P = 0.01, respectively). Average PRNFL thickness and quadrantal PRNFL were all significantly reduced after decompression surgery in all of the cases (P = 0.024). Conclusions PRNFL thickness measured by SD-OCT is correlated with visual recovery after decompression surgery in TED-related CON. In eyes with severe VF defect (MD worse than −10 dB), the ones with higher preoperative PRNFL thicknesses (>65 μm) had more improvement in MD compared with those with thin PRNFL measures (<60 μm).
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Affiliation(s)
- Mohammad Taher Rajabi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Ojani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Riazi Esfahani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Zia Tabatabaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Bagher Rajabi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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