Department of Ophthalmology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China.
Department of Endocrinology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China.
BMJ Open Ophthalmol. 2024 Oct 14;9(1):e001443. doi: 10.1136/bmjophth-2023-001443.
To investigate the change in choroidal components of patients with Graves' ophthalmopathy (GO) with different degrees of disease activity and severity by using the image binarisation method of optical coherence tomography (OCT).
This cross-sectional study included 151 eyes of 90 patients with GO. Patients were grouped according to the clinical activity score (CAS) and disease severity. Total choroidal area (TCA), luminal area, stromal area (SA) and choroidal vascularity index (CVI) were acquired by image binarisation of the OCT. Ocular parameters between groups were compared using generalised estimating equations, accounting for intereye correlation and adjusting for relevant factors.
As for the included eyes, 104 eyes were inactive GO and 47 eyes were active GO. Local choroidal thicknesses were thicker in active GO than in inactive GO. TCA and SA were significantly larger in active GO than in inactive GO group (3.44±0.91 mm vs 3.14±0.88 mm, p=0.046; 1.16 (1.03-1.50) mm vs 1.10 (0.96-1.27) mm, p=0.002, respectively). CAS was positively correlated with TCA (r=0.171, p=0.036) and SA (r=0.172, p=0.035), and negatively associated with CVI (r=-0.174, p=0.032). In multiple regression models, age, diopter and intraocular pressure (IOP) exhibited significant correlations with the SA (β=-0.006, p=0.010; β=0.076, p<0.001; β=0.015, p=0.010, respectively).
Thickened choroid was observed in active GO compared with inactive GO. The proportional increase of SA was augmented as the disease activity progressed. Age, diopter and IOP were independent factors that affected choroidal area and components in patients with GO. Multicentre prospective cohort studies with a large sample size are still needed.
利用光学相干断层扫描（OCT）的图像二值化方法，研究不同疾病活动度和严重程度的格雷夫斯眼病（GO）患者脉络膜成分的变化。
本横断面研究纳入了 90 例 GO 患者的 151 只眼。根据临床活动评分（CAS）和疾病严重程度将患者分为不同组。通过 OCT 的图像二值化获取总脉络膜面积（TCA）、管腔面积、基质面积（SA）和脉络膜血管指数（CVI）。使用广义估计方程比较各组之间的眼部参数，考虑到眼间相关性，并调整相关因素。
在纳入的眼中，104 只为非活动性 GO，47 只为活动性 GO。活动性 GO 的局部脉络膜厚度较非活动性 GO 厚。与非活动性 GO 组相比，活动性 GO 组的 TCA 和 SA 显著增大（3.44±0.91 mm 比 3.14±0.88 mm，p=0.046；1.16（1.03-1.50） mm 比 1.10（0.96-1.27） mm，p=0.002）。CAS 与 TCA（r=0.171，p=0.036）和 SA（r=0.172，p=0.035）呈正相关，与 CVI（r=-0.174，p=0.032）呈负相关。在多元回归模型中，年龄、屈光度和眼内压（IOP）与 SA 显著相关（β=-0.006，p=0.010；β=0.076，p<0.001；β=0.015，p=0.010）。
与非活动性 GO 相比，活动性 GO 中观察到脉络膜增厚。随着疾病活动度的进展，SA 的比例增加。年龄、屈光度和 IOP 是影响 GO 患者脉络膜面积和成分的独立因素。仍需要进行多中心前瞻性队列研究，样本量更大。
