Abstract
Objectives The objective of the study is to observe changes in choroidal thickness (CT) in patients with Graves' ophthalmopathy using spectral-domain optical coherence tomography (SD-OCT). Methods The right eyes of 36 patients (27 females and 9 males) with Graves' ophthalmopathy (GO) and those of 36 age-, gender-, and diopter-level-matched healthy participants were evaluated. The patients' data were obtained within 3 months after the onset of Graves' disease (GD). Thyroid hormone levels and thyroid-stimulating hormone receptor antibody (TRAb) levels were measured, and the degree of exophthalmos was measured in all patients. Activity is measured by the clinical activity score (CAS). A horizontal scan centered on the fovea was performed in all participants. Five points of choroidal thickness were measured at the fovea (SFCT) and at 1500 μm nasal (N1500), 3000 μm nasal (N3000), 1500 μm temporal (T1500), and 3000 μm temporal (T3000) to the fovea. Results The CT measurements obtained were (mean ± SD) 313.47 ± 100.32 μm, 279.22 ± 85.80 μm, 214.64 ± 75.52 μm, 313.19 ± 80.36 μm, and 298.14 ± 82.75 μm in patients with GO and were 256.33 ± 50.18 μm, 223.14 ± 59.61 μm, 176.69 ± 60.66 μm, 250.92 ± 52.184 μm, and 239.47 ± 60.35 μm in the control group at the foveal, N1500, N3000, T1500, and T3000 measurement points, respectively. The CT in GO patients was significantly increased at all the points compared with the control group (P < 0.05). There was no relationship between the CT and CAS, the degree of exophthalmos, triiodothyronine (T3), tetraiodothyronine (T4), thyroid-stimulating hormone (TSH), or TRAb levels in GO. Conclusions CT was found to be increased in GO patients and had poor relationship with CAS, exophthalmos, and thyroid function tests.
Highlights
Graves’ disease (GD) is a common kind of autoimmune thyroid disease
A remarkable complication of GD is ocular injures, known as Graves’ ophthalmopathy (GO). e pathogenesis of GO involves massive cellular and fluid infiltration of the soft tissues of bony orbit and extraocular muscles; retracted upper eyelids, protuberant eyeballs, and limited eye movements are found in GO patients. ere is an inflammatory stage at the onset of GO, and injection or chemosis of the ocular surface, corneal fluorescein staining, and meibomian gland dysfunction may occur during this stage
E exophthalmometric value ranged from 12 mm to 30 mm. e clinical activity score (CAS) ranged from 0 to 7 and 22.2% of the patients had active GO (8/36) when the ocular examinations were performed. e average values of the choroidal thickness (CT) are shown in Table 2. e CT was greater in the GO group than that in the control group. ere were statistically significant differences observed at all the points
Summary
Graves’ disease (GD) is a common kind of autoimmune thyroid disease. It is characterized by diffuse goiter and thyrotoxicosis and may be accompanied by an infiltrative ophthalmopathy and occasionally by an infiltrative dermopathy. Studies on choroidal thickness (CT) have become widespread in systemic diseases since it was first reported that measurements could be made in vivo with optical coherence tomography (OCT) [6]. E control group consisted of age-, gender-, and diopter level-matched healthy individuals without any ocular disease other than refractive errors.
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