Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Pisa, Italy.
Int Ophthalmol. 2020 Sep;40(9):2129-2137. doi: 10.1007/s10792-020-01392-7. Epub 2020 May 2.
To compare optic disc, retinal and choroidal measurements in patients with Graves' disease with or without orbitopathy, and healthy controls.
Optical coherence tomography and Heidelberg retinal tomography were performed in 40 patients with Graves' orbitopathy (GO), 40 subjects with Graves's disease (GD) with no sign of orbitopathy and 40 healthy controls. Degree of exophthalmos, ocular alignment, clinical activity score (CAS), choroidal thickness, retinal thickness, ganglion cell layer (GCL) thickness, disc area, cup area, rim area, cup/disc area ratio, linear cup/disc ratio and mean peripapillary retinal nerve fibre layer thickness were analysed.
GO patients and healthy controls significantly differ regarding mean central retinal thickness (275 ± 19 µm and 285 ± 20 µm, P = 0.017); mean central GCL thickness (14.87 ± 3.0 µm and 17.92 ± 5.02 µm, P = 0.001); mean disc area (2.00 ± 0.44 mm and 1.72 ± 0.37 mm, P = 0.003); mean cup area (0.53 ± 0.52 mm and 0.31 ± 0.20 mm, P = 0.003); cup/disc area ratio (0.22 ± 0.10 and 0.17 ± 0.08, P = 0.010); and linear cup/disc ratio (0.47 ± 0.15 and 0.40 ± 0.13, respectively, P = 0.011). No difference was found between patients without orbitopathy and healthy controls. No significant difference was found regarding the choroidal thickness between the three groups. There was no statistically significant relationship between retinal thickness, ganglion cell layer thickness, mean disc area, mean cup area, cup/disc area ratio, linear cup/disc ratio, CAS, exophthalmometric value and ocular alignment.
GO patients showed significant changes in foveal and GCL thickness, and optic nerve head morphology suggesting a possible influence of the orbital inflammatory process.
比较 Graves 病伴或不伴眼病患者与健康对照者的视盘、视网膜和脉络膜测量值。
对 40 例 Graves 眼病（GO）患者、40 例无眼病的 Graves 病（GD）患者和 40 例健康对照者进行光学相干断层扫描和海德堡视网膜断层扫描。分析眼球突出度、眼球位置、临床活动评分（CAS）、脉络膜厚度、视网膜厚度、神经节细胞层（GCL）厚度、视盘面积、杯面积、环区面积、杯/盘面积比、线性杯/盘比和平均视盘周围视网膜神经纤维层厚度。
GO 患者与健康对照组的平均中央视网膜厚度（275±19 µm 和 285±20 µm，P=0.017）、平均中央 GCL 厚度（14.87±3.0 µm 和 17.92±5.02 µm，P=0.001）、平均视盘面积（2.00±0.44 mm 和 1.72±0.37 mm，P=0.003）、平均杯面积（0.53±0.52 mm 和 0.31±0.20 mm，P=0.003）、杯/盘面积比（0.22±0.10 和 0.17±0.08，P=0.010）和线性杯/盘比（0.47±0.15 和 0.40±0.13，P=0.011）存在显著差异。无眼病的 GD 患者与健康对照组之间无差异。三组间脉络膜厚度无显著差异。视网膜厚度、GCL 厚度、平均视盘面积、平均杯面积、杯/盘面积比、线性杯/盘比、CAS、眼球突出度值和眼球位置之间无统计学显著相关性。
GO 患者的黄斑和 GCL 厚度以及视盘神经头形态发生显著变化，提示眼眶炎症过程可能有一定影响。
