Color Doppler imaging of orbital vasculature before and after orbital decompression in thyroid eye disease

Jamshidian-Tehrani, Mansooreh; Nekoozadeh, Shahbaz; Alami, Elham; Ghadimi, Hadi; Amin, Nikhil; Ameli, Kambiz; Kashani, S Sharif; Kashkouli, Mohsen Bahmani; Sadeghi-Tari, Ali

doi:10.1080/01676830.2018.1513537

Cited by 11 publications

(10 citation statements)

References 27 publications

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“…Changes in orbital blood flow in patients with TED have been reported in previous studies ( 9 – 11 , 22 – 24 ). Using color Doppler sonography, Somer et al ( 23 ) reported lower mean superior ophthalmic vein blood flow velocity in patients with TED compared with those without TED.…”

Section: Discussionsupporting

confidence: 77%

Evaluation of Microcirculation in Optic Nerve Head Using Laser Speckle Flowgraphy in Active Thyroid Eye Disease

Tsai

Chu

et al. 2022

BioMed Research International

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Background. Laser speckle flowgraphy (LSFG) can be used to estimate optic nerve blood flow. This study used LSFG to evaluate optic nerve microcirculation in patients with thyroid eye disease (TED). Methods. This was a retrospective review of patients with active TED who underwent LSFG between October 2020 and June 2021. The mean blur rate (MBR) for different severities of active TED was analyzed by one-way analysis of variance (ANOVA). Results. A total of 30 patients (60 eyes) with a diagnosis of active TED who underwent LSFG were included. The mean age was 49 (range, 33–74) years. Mean best-corrected visual acuity was the worst in the group with sight-threatening active TED ( 0.29 ± 0.33 logarithm of the minimum angle of resolution, p = 0.01 ). The MBR-overall was the highest in the group with mild active TED ( 28.5 ± 2.7 ), followed by that in the moderate to severe ( 23.6 ± 3.2 ), and in the sight-threatening ( 20.2 ± 4.3 ) active TED groups ( p < 0.001 ). The MBR-vessel was 57.1, 47.0, and 39.3 in the mild, moderate to severe, and sight-threatening active TED groups, respectively ( p < 0.001 ). The MBR-tissue was 16.9, 14.4, and 12.0 in the mild, moderate to severe, and sight-threatening active TED groups, respectively ( p < 0.001 ). Conclusions. This study demonstrates that optic nerve blood flow is lower with more severe active TED. In addition, LSFG is an effective, objective, and noninvasive method for evaluating the severity of TED.

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Section: Discussionsupporting

confidence: 77%

Evaluation of Microcirculation in Optic Nerve Head Using Laser Speckle Flowgraphy in Active Thyroid Eye Disease

Tsai

Chu

et al. 2022

BioMed Research International

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“…TAO is a common orbital disorder that can lead to dysthyroid optic neuropathy (DON) by compression of the optic nerve by congested tissues and extraocular muscles. The role of vascular blood flow in the pathogenesis of optic neuropathy has been widely investigated with several methods; different studies with Doppler ultrasonography have demonstrated that increase in intra-orbital pressure in TAO patients leads to severe stasis in the superior ophthalmic vein [ 11 – 13 ]; also, other studies observed an increased resistance in ophthalmic artery and in central retinal artery in TAO patients, which decreases after orbital decompression [ 14 , 15 ]. Some studies with OCTA observed a reduction in macular density in patients with active and inactive TAO [ 16 ], other studies observed a greater macular density in inactive TAO patients [ 17 ] and other studies showed an increase in macular density in active TAO patients [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of peripapillary vascular flow in patients with Thyroid-Associated Ophthalmopathy (TAO) by OCT Angiography

Noce

Roda

Valsecchi

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose To evaluate changes in peripapillary vascular blood flow indices (PVBFI) in patients with thyroid-associated ophthalmopathy (TAO) using OCT angiography (OCTA) technology. Methods Patients with TAO and control subjects matched for age and sex were included in the study. Eye examination, Clinical Activity Score (CAS) evaluation and OCTA scan analysis (Topcon ImageNet 6; DRI OCT Triton, Topcon Corporation) were performed. In particular, PVBFI of the superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina (OR) and choriocapillaris (CC) layers were obtained by OCTA and extracted from 8-bit greyscale OCT images using the ImageJ software package. Results Twenty-six patients with TAO (19 females, mean age 54.7 ± 5.2 and 7 males, mean age 51.4 ± 16.3) were compared with 26 healthy subjects (15 females, mean age 48.2 ± 14.1 and 11 males, mean age 53.1 ± 15.2). Both DCP-PVBF and CC-PVBFI were significantly reduced in TAO patients compared to control eyes (28.6 ± 2.1 vs. 29.7 ± 0.93, p = 0.002; 46.5 ± 1.72 vs. 47.2 ± 1.2, p = 0.019 respectively); on the other hand, no statistically significant differences were found in SCP-PVBFI and OR-PVBFI in TAO patients compared to healthy subjects (p > 0.05). Also, CC-PVBFI was associated with elevated values of CAS (p = 0.018) and ROC curve showed that patients with elevated CC-PVBFI were correlated with active TAO (CAS > 3) (p = 0.012). Conclusions TAO disease may be associated with changes in DCP-PVBFI and CC-PVBFI; also, CC-PVBFI seems to correlate with disease activity.

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“…We postulate ophthalmologic improvement may have occurred through bone removal adjacent to the medial cavernous sinus and optic canal, relieving compression of the abducens nerve and/or its microvasculature. 5 Decompression may additionally have altered flow and turbulence within the cavernous sinus, allowing self-thrombosis of the fistulous vessels. An additional possibility is that auto-thrombosis occurred with watchful waiting in the absence of surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Endonasal Orbital Apex Decompression for Carotid Cavernous Fistula

et al. 2021

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Significance Statement This case report demonstrates a novel approach to treating a rare indirect carotid cavernous fistula (CCF) and associated abducens palsy. Although endovascular treatment is the standard of care in the management of CCFs, it was contraindicated in this patient. Instead, she underwent an endoscopic endonasal approach (EEA) with decompression of the medial orbital apex, including the cavernous sinus and optic nerve, with complete resolution of headache, lateral gaze palsy, and diplopia within 2 months.

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Color Doppler imaging of orbital vasculature before and after orbital decompression in thyroid eye disease

Abstract: Orbital decompression procedure led to a significant reduction of RI in both CRA and OA in patients with TED.

Cited by 11 publications

References 27 publications

Evaluation of Microcirculation in Optic Nerve Head Using Laser Speckle Flowgraphy in Active Thyroid Eye Disease

Evaluation of Microcirculation in Optic Nerve Head Using Laser Speckle Flowgraphy in Active Thyroid Eye Disease

Evaluation of peripapillary vascular flow in patients with Thyroid-Associated Ophthalmopathy (TAO) by OCT Angiography

Endoscopic Endonasal Orbital Apex Decompression for Carotid Cavernous Fistula

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