Purpose: 

To compare the retinal peripapillary capillary (RPC) vessel density (VD) between 5 groups of patients on the spectrum of thyroid eye disease (TED).

Method: 

This is a prospective comparative study looking at 5 groups of patients who were consecutively included from January 2018 to March 2021. They were composed of: Healthy volunteers (39 eyes and 20 subjects), patients with Graves’ disease without TED (26 eyes and 13 patients), mild TED (28 eyes and 14 patients), moderate-severe TED (30 eyes and 17 patients), and TED with dysthyroid optic neuropathy (DON) (21 eyes and 12 patients). Ocular and periocular examination, visual field indices, RPC-VD (with optical coherence tomography angiography), and retinal nerve fiber layer, and macular ganglion cell complex thickness were recorded.

Result: 

An initial insignificant (0.5 < p < 0.9) rise in the peripapillary-VD (pp-VD) and whole image-VD (wi-VD) from the healthy subject to the Graves’ disease without TED was followed by a significant (p = 0.001) fall in RPC-VD in different severity grades of the TED. Paired comparison between the 5 groups showed that the statistically significant fall from the Graves’ disease group occurred in the moderate-severe and DON groups (0.001 ≤ p ≤ 0.04). No variable significantly affected the VD (0.08 ≤ p ≤ 0.9). A lower wi-VD and pp-VD were significantly (0.001 ≤ p ≤ 0.009) correlated with the impaired optic nerve functional and structural tests. The sensitivity and specificity of wi-VD (81% and 76%) and pp-VD (69% and 71%) for detecting the DON were statistically significant (p < 0.001).

Conclusion: 

Despite an insignificant rise in the wi- and pp-VD from the healthy volunteers to the patients with Graves’ disease without TED, VD showed a declining trend in the course of patients with TED, which was statistically significant in the moderate-severe TED and DON groups.

中文翻译：

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视神经头血管密度从没有 TED 的格雷夫斯病到 TED 甲状腺功能不良视神经病变：视神经头缺血起作用吗？

目的： 

比较 5 组甲状腺眼病 (TED) 患者的视网膜周围毛细血管 (RPC) 血管密度 (VD)。

方法： 

这是一项前瞻性比较研究，着眼于 2018 年 1 月至 2021 年 3 月连续纳入的 5 组患者。他们由：健康志愿者（39 只眼睛和 20 名受试者）、未接受 TED 的格雷夫斯病患者（26 只眼睛和 13 名受试者）组成。患者）、轻度 TED（28 只眼和 14 名患者）、中重度 TED（30 只眼和 17 名患者）以及 TED 伴有甲状腺功能障碍性视神经病变 (DON)（21 只眼和 12 名患者）。记录眼部和眼周检查、视野指数、RPC-VD（光学相干断层扫描血管造影）、视网膜神经纤维层和黄斑神经节细胞复合体厚度。

结果： 

从健康受试者到没有 TED 的格雷夫斯病，视乳头周围 VD (pp-VD) 和整个图像 VD (wi-VD)最初不显着 (0.5 < p < 0.9) 上升，随后显着 ( p = 0.001）在 TED 的不同严重等级中 RPC-VD 下降。5组之间的配对比较显示，中重度组和DON组中格雷夫斯病组的统计学显着下降（0.001≤p≤0.04 ）。没有变量显着影响 VD (0.08 ≤ p ≤ 0.9)。较低的 wi-VD 和 pp-VD与视神经功能和结构测试受损显着相关 (0.001 ≤ p ≤ 0.009)。wi-VD（81% 和 76%）和 pp-VD（69% 和 71%）检测 DON 的敏感性和特异性具有统计学意义（p < 0.001）。

结论： 

尽管从健康志愿者到没有 TED 的格雷夫斯病患者，wi- 和 pp-VD 没有显着上升，但 VD 在 TED 患者的病程中表现出下降趋势，这在中重度 TED 和 TED 患者中具有统计学意义。呕吐毒素组。