光学相干断层扫描（OCT）及OCT血管造影在甲状腺相关性眼病中的早期诊断价值

The early diagnostic value of optical coherence tomography (OCT) and OCT angiography in thyroid-associated ophthalmopathy.

作者信息

Xu Bei, Wang Sha, Chen Lu, Tan Jia

机构信息

Eye Center of Xiangya Hospital, Central South University, Changsha, China.

Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, China.

出版信息

Ther Adv Chronic Dis. 2023 May 10;14:20406223231166802. doi: 10.1177/20406223231166802. eCollection 2023.

DOI:10.1177/20406223231166802

PMID:37187796

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10176590/

Abstract

BACKGROUND

The retinal microvascular density changes have been identified in thyroid-associated ophthalmopathy (TAO) patients. Whereas a lack of research has been done on the diagnostic ability of optical coherence tomography (OCT) combined with optical coherence tomography angiography (OCTA) parameters.

OBJECTIVES

This study aims to evaluate the retina perfusion variations in eyes with active and stable TAO and its diagnostic abilities using OCT and OCTA.

DESIGN

This is cohort longitudinal retrospective study.

METHODS

A total of 51 patients with TAO and 39 healthy controls (HCs) were recruited. The TAO eyes were divided into active and stable stage groups. The foveal avascular zone (FAZ), macular perfusion density (mPD), and peripapillary PD were measured by OCTA. The peripapillary retinal nerve fiber layer (RNFL), central retinal thickness (CRT), and whole macular volume (wMV) were measured by OCT. Visual evoked potential (VEP) and visual field (VF) were also assessed.

RESULTS

The mPD of the superficial retinal capillary plexus (SRCP) was significantly different in all subfields among active, stable, and HC groups ( < 0.05) except for the temporal inner ( = 0.137), and the active group achieved the lowest PD. The FAZ size increased significantly in the active and stable groups compared with the HC group ( < 0.001). Significant difference was observed in mPD of deep retinal capillary plexus (DRCP) in all quadrants among three groups ( < 0.05). Moreover, PD parameters of optic nerve head (ONH) and radial peripapillary capillary plexus (RPCP) showed a different trend among three groups ( < 0.05). The -value of visual field-mean deviation (VF-MD) of TAO with DRCP-whole PD (wPD) and RPCP-wPD was 0.421 and 0.299, respectively ( < 0.05). The DRCP-wPD in OCTA and RNFL in OCT were significantly higher in area under the receiver operating characteristic curve (AUC) than that of HC eyes.

CONCLUSION

OCT and OCTA can noninvasively detect the peripapillary and macular changes in various stages of TAO patients, and it might be a high diagnostic value tool to monitor the TAO progression.

摘要

背景

甲状腺相关眼病（TAO）患者存在视网膜微血管密度变化。然而，关于光学相干断层扫描（OCT）联合光学相干断层扫描血管造影（OCTA）参数的诊断能力研究较少。

目的

本研究旨在评估活动期和稳定期TAO患者眼睛的视网膜灌注变化及其使用OCT和OCTA的诊断能力。

设计

这是一项队列纵向回顾性研究。

方法

共招募51例TAO患者和39名健康对照者（HC）。TAO患眼分为活动期和稳定期组。通过OCTA测量黄斑无血管区（FAZ）、黄斑灌注密度（mPD）和视乳头周围灌注密度。通过OCT测量视乳头周围视网膜神经纤维层（RNFL）、中央视网膜厚度（CRT）和整个黄斑体积（wMV）。还评估了视觉诱发电位（VEP）和视野（VF）。

结果

除颞内侧（P = 0.137）外，活动期、稳定期和HC组所有子区域的浅表视网膜毛细血管丛（SRCP）的mPD均有显著差异（P < 0.05），活动期组的PD最低。与HC组相比，活动期和稳定期组的FAZ大小显著增加（P < 0.001）。三组所有象限的深层视网膜毛细血管丛（DRCP）的mPD均有显著差异（P < 0.05）。此外，视神经乳头（ONH）和视乳头周围放射状毛细血管丛（RPCP）的灌注密度参数在三组中呈现不同趋势（P < 0.05）。TAO患者DRCP全层灌注密度（wPD）和RPCP - wPD的视野平均偏差（VF - MD）的P值分别为0.421和0.299（P < 0.05）。OCTA中的DRCP - wPD和OCT中的RNFL在受试者操作特征曲线下面积（AUC）显著高于HC眼。