Altered peripapillary vessel density and nerve fiber layer thickness in thyroid-associated ophthalmopathy using optical coherence tomography angiography

Jian, Huan; Wang, Yujiao; Ou, Luyu; He, Weimin

doi:10.1007/s10792-021-02051-1

Cited by 12 publications

(10 citation statements)

References 22 publications

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“…21 Furthermore, in TAO patients with dysthyroid optic neuropathy (DON), the total peripapillary vessel density and RNFL thickness were significantly lower than those without DON. 22 Since the IOP was higher in the DON group than other groups, high IOP should be as a risk factor for decreased retinal vessel and RNFL thickness in TAO patients. Considering all these findings mentioned above, the changes in retinal vessels and RNFL may mainly result from alterations in hormone levels (especially thyroid hormones) as well as elevated orbital pressure and IOP.…”

Section: Discussionmentioning

confidence: 86%

“…In patients with TAO, significant increases were found in macular and foveal vascular density and perfusion densities, while a significant decrease was found in the foveal avascular zone area when compared with the control group 21 . Furthermore, in TAO patients with dysthyroid optic neuropathy (DON), the total peripapillary vessel density and RNFL thickness were significantly lower than those without DON 22 . Since the IOP was higher in the DON group than other groups, high IOP should be as a risk factor for decreased retinal vessel and RNFL thickness in TAO patients.…”

Section: Discussionmentioning

confidence: 95%

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Retinal Photograph-based Deep Learning System for Detection of Thyroid-Associated Ophthalmopathy

Jiang,

Dong,

Luo

et al. 2023

Journal of Craniofacial Surgery

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Background: The diagnosis of thyroid-associated ophthalmopathy (TAO) usually requires a comprehensive examination, including clinical symptoms, radiological examinations, and blood tests. Therefore, cost-effective and noninvasive methods for the detection of TAO are needed. This study aimed to establish a deep learning-based system to detect TAO based on retinal photographs. Materials and methods: The multicenter observational study included retinal photographs taken from TAO patients and normal participants in 2 hospitals in China. Forty-five-degree retinal photographs, centered on the midpoint between the optic disc and the macula, were captured by trained ophthalmologists. The authors first trained a convolutional neural network model to identify TAO using data collected from one hospital. After internal validation, the model was further evaluated in another hospital as an external validation data set. Results: The study included 1182 retinal photographs of 708 participants for model development, and 365 retinal photographs (189 participants) were obtained as the external validation data set. In the internal validation, the area under the receiver operator curve was 0.900 (95% CI: 0.889–0.910) and the accuracy was 0.860 (95% CI: 0.849–0.869). In the external data set, the model reached an area under the curve of 0.747 (95% CI: 0.728–0.763) and achieved an accuracy of 0.709 (95% CI: 0.690–0.724). Conclusions: Deep learning-based systems may be promising for identifying TAO in normal subjects using retinal fundus photographs. It may serve as a cost-effective and noninvasive method to detect TAO in the future.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 95%

Retinal Photograph-based Deep Learning System for Detection of Thyroid-Associated Ophthalmopathy

Jiang,

Dong,

Luo

et al. 2023

Journal of Craniofacial Surgery

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“…They found that VD had no significant relation with different clinical variables [ 17 ]. Jian et al also found that the ONH VD was lower in patients with TED who had optic neuropathy [ 18 ]. In another study by Del Noce et al, there was a significant decrease in the peripapillary choriocapillaris and deep capillary plexus VD in patients with TED compared to healthy age and gender-matched controls.…”

Section: Discussionmentioning

confidence: 99%

Optic nerve head optical coherence tomography angiography findings in patients with thyroid eye disease: a case–control study

et al. 2022

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Background To evaluate changes in the vessel density (VD) of the optic nerve head (ONH) microvasculature in thyroid eye disease (TED) using optical coherence tomography angiography (OCTA). This study aimed to applicate the OCTA as a noninvasive modality in screening TED patients to assess sub-clinical changes. Methods In a cross-sectional study, the control group patients were healthy individuals with no ocular abnormalities and were euthyroid. All patients with TED had clinical features of the disease. We divided them into two groups using the clinical activity score (CAS). Patients with CAS scores 0–2 were categorized as group A, and scores three or more as group B. All vessels (AV) and small vessels (SV) VD inside disc and radial peripapillary capillary network were measured using the ONH-OCTA. Results We evaluated 29 patients with TED and 28 healthy controls. The mean whole image AV VD (mean ± SD: 56.33 ± 2.56, p-value = 0.17) and the mean whole image SV VD (mean ± SD: 49.94 ± 2.56, p-value = 0.16) in the TED group had no statically significant difference compared with the control group (AV mean ± SD: 57.20 ± 20.22, SV mean ± SD: 50.84 ± 2.23). We found a non-significant decrease in AV and SV radial peripapillary capillary VD in the TED group. There was a significant decrease in the mean whole image AV VD (mean ± SD: 54.83 ± 3.07, p-value = 0.005) and the mean whole image SV VD (mean ± SD: 48.60 ± 3.18, p-value = 0.013) in CAS group B compared to group A (AV mean ± SD: 57.45 ± 1.33, SV mean ± SD: 50.95 ± 1.37). Conclusion Our study showed non-significant ONH vascular alterations in patients with TED, including reduced VD of ONH in the radial peripapillary capillary. Patients with higher CAS scores had a more noticeable decrease in ONH microvasculature.

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“…109 Peripapillary vessel density was significantly lower in DON patients in comparison with other TED patients and healthy controls. 110 In a study on 24 eyes of 12 patients, eyes with DON displayed a reduction in (peri)papillary vessel density after decompression surgery more often than eyes without DON, though the small sample size hinders the generalization of the results. 111 Overwhelming evidence for the routine application of optical CT and optical CT-angiography in the diagnosis and management of TED and DON has not yet been delivered, and large, prospective studies exploring these tools are needed.…”

Section: Perimetry Is a Useful Ancillary Test For The Diagnosis And F...mentioning

confidence: 99%

Dysthyroid Optic Neuropathy

Potvin,

Pakdel,

Saeed

2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose:Dysthyroid optic neuropathy (DON) is a sight-threatening complication of thyroid eye disease (TED). This review provides an overview of the epidemiology, pathogenesis, diagnosis, and current therapeutic options for DON.Methods:A literature review.Results:DON occurs in about 5% to 8% of TED patients. Compression of the optic nerve at the apex is the most widely accepted pathogenic mechanism. Excessive stretching of the nerve might play a role in a minority of cases. Increasing age, male gender, smoking, and diabetes mellitus have been identified as risk factors. Diagnosis of DON is based on a combination of ≥2 clinical findings, including decreased visual acuity, decreased color vision, relative afferent pupillary defect, visual field defects, or optic disc edema. Orbital imaging supports the diagnosis by confirming apical crowding or optic nerve stretching. DON should be promptly treated with high-dose intravenous glucocorticoids. Decompression surgery should be performed, but the response is incomplete. Radiotherapy might play a role in the prevention of DON development and may delay or avoid the need for surgery. The advent of new biologic-targeted agents provides an exciting new array of therapeutic options, though more research is needed to clarify the role of these medications in the management of DON.Conclusions:Even with appropriate management, DON can result in irreversible loss of visual function. Prompt diagnosis and management are pivotal and require a multidisciplinary approach. Methylprednisolone infusions still represent first-line therapy, and surgical decompression is performed in cases of treatment failure. Biologics may play a role in the future.

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Altered peripapillary vessel density and nerve fiber layer thickness in thyroid-associated ophthalmopathy using optical coherence tomography angiography

Cited by 12 publications

References 22 publications

Retinal Photograph-based Deep Learning System for Detection of Thyroid-Associated Ophthalmopathy

Retinal Photograph-based Deep Learning System for Detection of Thyroid-Associated Ophthalmopathy

Optic nerve head optical coherence tomography angiography findings in patients with thyroid eye disease: a case–control study

Dysthyroid Optic Neuropathy

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