Evaluation of Retinal Neurodegeneration and Choroidal Thickness in Patients with Inactive Gravesʼ Ophthalmopathy

Abstract

Purpose The study was conducted for the assessment of the retinal nerve fiber layer, ganglion cell layer, and subfoveal choroidal thickness changes in patients with inactive Gravesʼ ophthalmopathy (GO) using swept-source optical coherence tomography (SS-OCT) before the development of active GO findings.

Materials and Methods The cross-sectional designed study consisted of patients with inactive Gravesʼ ophthalmopathy (study group) and healthy subjects (control group). The thicknesses of the retinal ganglion cell layer, retinal nerve fiber layer, and subfoveal choroid (SFCT) were measured using SS-OCT with deep range imaging technology to compare these parameters between the study and control groups.

Result Patients with inactive Gravesʼ ophthalmopathy had higher values of intraocular pressure but similar best-corrected visual acuity (p = 0.001, p = 0.232, respectively). The retinal nerve fiber layer was thinner only in the superior zone of the study group (p = 0.039), whereas similar values were noted in the temporal, nasal, and inferior areas as well as the average thickness. We did not observe any statistically significant difference in any sector of the ganglion cell layer between the study and control groups. A thicker mean subfoveal choroidal thickness value was measured in patients with inactive Gravesʼ ophthalmopathy than in healthy subjects (p = 0.013) in correlation with a clinical activity score (p = 0.046).

Conclusion SS-OCT showed minimal retinal neurodegenerative alteration and significant choroidal thickening in inactive GO. Thus, SS-OCT might be a beneficial technique to detect retinal neurodegenerative and choroidal changes earlier in the stage of inactive GO before the development of active GO signs, which may affect the time and type of treatment modalities to prevent further ocular or systemic complications. Additionally, SFCT may be a good indicator for assessment of the severity of Gravesʼ disease.

Zusammenfassung

Zweck Die Studie wurde durchgeführt, um die Veränderungen der Nervenfaserschicht der Netzhaut, der Ganglienzellschicht und der subfovealen Dicke der Aderhaut bei Patienten mit inaktiver Graves-Ophthalmopathie (GO) vor der Entwicklung von aktiven GO-Befunden mithilfe der optischen Kohärenztomografie (SS-OCT) zu untersuchen.

Material und Methoden Die Querschnittsstudie bestand aus Patienten mit inaktiver Graves-Ophthalmopathie (Studiengruppe) und gesunden Probanden (Kontrollgruppe). Die Dicken der Ganglienzellschicht der Netzhaut, der Nervenfaserschicht der Netzhaut und der subfovealen Aderhaut (SFCT) wurden unter Verwendung von SS-OCT mit Tiefenbildgebungstechnologie gemessen, um diese Parameter zwischen der Studien- und der Kontrollgruppe zu vergleichen.

Ergebnisse Patienten mit inaktiver Graves-Ophthalmopathie hatten höhere Augeninnendruckwerte, aber eine ähnliche bestkorrigierte Sehschärfe (p = 0,001, p = 0,232). Die Netzhautnervenfaserschicht war nur in der oberen Zone der Studiengruppe dünner (p = 0,039), während ähnliche Werte im temporalen, nasalen und unteren Bereich sowie in der durchschnittlichen Dicke festgestellt wurden. Wir haben in keinem Sektor der Ganglienzellschicht einen statistisch signifikanten Unterschied zwischen der Studien- und der Kontrollgruppe beobachtet. Bei Patienten mit inaktiver Graves-Ophthalmopathie wurde in Korrelation mit dem klinischen Aktivitätsscore (p = 0,046) ein dickerer mittlerer subfovealer Wert für die Dicke der Aderhaut gemessen als bei gesunden Probanden (p = 0,013).

Schlussfolgerung Die SS-OCT zeigte eine minimale neurodegenerative Veränderung der Netzhaut und eine signifikante Verdickung der Aderhaut bei inaktiver GO. Daher könnte die SS-OCT eine vorteilhafte Technik sein, um neurodegenerative und choroidale Veränderungen der Netzhaut früher im Stadium inaktiver GO vor der Entwicklung aktiver GO-Zeichen zu erkennen, was die Zeit und Art der Behandlungsmodalitäten beeinflussen kann, um weitere okulare oder systemische Komplikationen zu verhindern. Darüber hinaus kann die SFCT ein guter Indikator für die Beurteilung der Schwere des Morbus Basedow sein.

Key words

inactive Gravesʼ ophthalmopathy - swept-source optical coherence tomography - neurodegeneration - retinal nerve fiber layer - ganglion cell layer - choroidal thickness

Schlüsselwörter

inaktive Graves-Ophthalmopathie - Swept-Source optische Kohärenztomografie - Neurodegeneration - Netzhautnervenfaserschicht - Ganglienzellschicht - Aderhautdicke

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