Abstract
PurposeThe aim of this study is to evaluate the changes in macular blood flow index (BFI) in patients with moderate to severe thyroid-associated orbitopathy (TAO) before and after pulse therapy and their relationship with clinical features and disease activity using angio-OCT technology.MethodsWe analyzed twenty-four eyes. Every patient underwent a complete eye examination and angio-OCT analysis (OCT Topcon ImageNet 6; DRI OCT Triton, Topcon Corporation) before (T0) and two months (T2) after pulse therapy. We analyzed macular vascular blood flow in four angiographic levels: superficial plexus (SP), deep plexus (DP), external retina (ER), and choriocapillaris (CC). We used the clinical activity score (CAS) score to define TAO as moderate or severe.ResultsMacular BFI significantly increased at T2 in the DP, ER, and CC (p < 0.01). CAS score (5.8 ± 0.8 vs. 3.9 ± 0.9, p < 0.01) and Hertel exophthalmometry values (22.6 ± 2.3 mm vs. 21.2 ± 2,5 mm, p < 0.01) improved for all patients at T2 compared T0. Mean IOP increased from 13.3 ± 2.8 mmHg to 14.3 ± 2.1 mmHg (p < 0.01). No correlation was found between CAS score and macular BFI in all the analyzed levels.ConclusionsPulse therapy treatment can change macular BFI. In particular, two months alter pulse therapy, all the patients show an increase in macular vascular blood flow in each angiographic level. According to our results, angio-OCT analysis of the macular BFI may be a useful tool in the follow-up of TAO patients after pulse therapy.
Highlights
Graves’ disease (GD) is an autoimmune disorder characterized by the excess production of thyroid hormones due to the overstimulation of the thyroid gland by thyrotropin1 3 Vol.:(0123456789)Graefe's Archive for Clinical and Experimental Ophthalmology (TSH)-receptor autoantibodies (TRAbs)
Results from our study suggest that optical coherence tomography angiography (OCTA) may be adopted as an useful, additive imaging technique in the management and follow-up of patients with thyroid-associated orbitopathy (TAO) treated with pulse therapy with methylprednisolone
Macular blood flow index (BFI) at T0 was lower in every angiographic level compared to macular BFI at T1
Summary
Graves’ disease (GD) is an autoimmune disorder characterized by the excess production of thyroid hormones due to the overstimulation of the thyroid gland by thyrotropin1 3 Vol.:(0123456789)Graefe's Archive for Clinical and Experimental Ophthalmology (TSH)-receptor autoantibodies (TRAbs). Graves’ disease (GD) is an autoimmune disorder characterized by the excess production of thyroid hormones due to the overstimulation of the thyroid gland by thyrotropin. Thyroid-associated orbitopathy is an autoimmune disorder related to GD. It occurs in up to 50% of individuals with GD. It may occur without current or prior hyperthyroidism, or in people who are hypothyroid due to chronic autoimmune Hashimoto’s thyroiditis [4]. Clinical manifestations of active thyroid-associated orbitopathy (TAO) can vary and may include conjunctival chemosis and injection, lid swelling, lid retraction, proptosis, strabismus, exposure keratopathy, and optic [5]. Clinical activity score (CAS) has been extremely used in assessing the activity level of TAO [7]
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