Assessment of Macular Parameters measured by OCT-A in patients with Graves’ Disease with and without Graves’ Orbitopathy

Author: Ana Rita Carreira (Portugal)

Co-authors: Tomás Loureiro, Filipe Moraes, Pedro Carreira, Ana Mafalda Pereira, João Cardoso, Nuno Campos

Purpose

Graves’ Orbitopathy (GO) has been associated with retinal changes due to hypoxia and ischemia caused by edema in the orbital tissues. Our aim was to assess macular vascular and morphological parameters measured by optical coherence tomography angiography (OCT-A) in patients with Graves’ Disease (GD), with and without GO.

Setting/Venue

Ophthalmology Department of Hospital Garcia de Orta E.P.E., Almada, Portugal.

Methods

This study included patients with GD, with and without GO, and healthy age-matched controls. Subjects underwent a complete ophthalmologic evaluation, including assessment of macular vascular and morphological parameters by OCT-A (Zeiss Cirrus HD-OCT 5000® with Angioplex 6x6mm device).

Results

Twenty-four eyes were included in the Control Group, with a mean age of 41.00±13.65 years, and 34 in the GD Group, 18 with GO and 16 without GO, with a mean age of 44.44±13.95 and 45.75±10.59 years, respectively. All patients with GO had inactive disease (mean CAS: 1.33±0.69). GO subgroup had the lowest macular thickness measurements, particularly mean foveal thickness (GO vs Controls: 251.38 ± 31.99 vs 258.42 ± 22.33µm, GO vs GD without GO: 251.38 ± 31.99 vs 255.31 ± 28.06µm, p0.05). Morphological parameters were equivalent between controls and GD without GO subgroup (p0.05). Macular density and flow were lower in patients with and without GO compared to controls (p0.05). Vascular parameters were equivalent among GD patients, except for central density and flow (GO vs GD without GO: 7.84 ± 4.11 vs 9.09 ± 4.40mm-1, p=0.04; 0.15 ± 0.09 vs 0.22 ± 0.02 mm-1, p=0.01, respectively).

Conlusions

Our results confirmed that GD negatively affects macular parameters. Although macular structural changes were associated with GO, there was a reduced superficial macular density and flow in patients with GD with and without GO. Therefore, it is possible that sustained inflammation may lead to subclinical macular vascular changes even before the development of GO.

Financial Disclosure

None.