甲状腺功能正常的Graves眼病脉络膜厚度增加:这是静脉充血的早期迹象吗?

The Increment of Choroidal Thickness in Euthyroid Graves' Ophthalmopathy: Is It an Early Sign of Venous Congestion?

作者信息

Cagiltay Eylem, Akay Fahrettin, Demir Ozgur, Aydın Erdinç, Akmaz Berkay, Pamuk Baris

机构信息

Department of Endocrinology and Metabolic Diseases, Sultan Abdulhamid Han Education and Research Hospital, Medical Sciences University, Istanbul, Turkey.

Department of Opthalmology, Ataturk Education and Research Hospital, Katip Celebi University, Izmir, Turkey.

出版信息

J Ophthalmol. 2018 Aug 28;2018:5891531. doi: 10.1155/2018/5891531. eCollection 2018.

Abstract

OBJECTIVE

Clinical manifestations of Graves' ophthalmopathy (GO) are caused by the overcompression of orbital tissues within the restricted orbital bone cavity. Impaired ocular blood flow may disrupt the retinal microstructure and functions. In this study, we aimed to investigate the macular and choroidal thickness changes in GO compared with healthy subjects.

MATERIALS AND METHODS

The study group comprised 50 adult patients with previously diagnosed Graves' disease with ophthalmopathy who were on antithyroid treatment. For the assessment of GO activity, the VISA (vision, inflammation, strabismus, and appearance) inflammatory score was used. When euthyroidism was achieved without side effects, the patients were referred to the ophthalmology clinic for spectral-domain optical coherence tomography (SD-OCT) evaluation.

RESULTS

Subfoveal, mean, and temporal choroidal thicknesses were increased significantly in the study group according to the controls. The mean choroidal thickness was elevated.

CONCLUSIONS

This elevation is because of the intraorbital inflammation even in this nonsevere GO group. Choroidal thickness might be affected from the venous obstruction and congestion in patients with GO. The elevation of the choroidal thickness might be an early sign of venous congestion that occurs before the elevation of intraocular pressure.

摘要

目的

格雷夫斯眼病(GO)的临床表现是由于眼眶骨腔内眶组织受压过度所致。眼部血流受损可能会破坏视网膜的微观结构和功能。在本研究中,我们旨在调查GO患者与健康受试者相比黄斑和脉络膜厚度的变化。

材料与方法

研究组包括50例先前诊断为格雷夫斯病伴眼病且正在接受抗甲状腺治疗的成年患者。为评估GO活动度,采用VISA(视力、炎症、斜视和外观)炎症评分。当患者实现甲状腺功能正常且无副作用时,将其转诊至眼科门诊进行频域光学相干断层扫描(SD-OCT)评估。

结果

与对照组相比,研究组的中心凹下、平均和颞侧脉络膜厚度显著增加。平均脉络膜厚度升高。

结论

即使在这个非重度GO组中,这种升高也是由于眶内炎症所致。GO患者的脉络膜厚度可能受静脉阻塞和充血影响。脉络膜厚度升高可能是眼内压升高之前发生静脉充血的早期迹象。

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