A Pilot Study of Subclinical Non-Capillary Peripapillary Perfusion Changes in Thyroid-Related Orbitopathy Detected Using Optical Coherence Tomography Angiography

Alexander Pinhas, Jorge S.Andrade Romo, Giselle Lynch, Davis B. Zhou, Maria V.Castanos Toral, Phillip A. Tenzel, Oscar Otero-Marquez, Shoshana Yakubova, Alexander Barash, David Della Rocca, Robert Della Rocca, Toco Y.P. Chui, Richard B. Rosen, Harsha S. Reddy

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: Hemodynamic changes surrounding the optic nerve head are known to occur in thyroid-related orbitopathy (TRO). This pilot study explores the capillary and non-capillary peripapillary perfusion changes of the retina in TRO eyes without dysthyroid optic neuropathy (DON) using optical coherence tomography angiography (OCT-A). Methods: Non-capillary and capillary peripapillary perfusion densities were calculated using single 4.5 × 4.5mm en face “RPC layer” OCT-A scans of 8 TRO patients without DON (8 eyes, mean age 40.6 years, range 23–69 years). Results were compared to a previously published dataset of 133 healthy controls (133 eyes, mean 41.5 years, range 11–83 years). The strength of association was measured between OCT-A perfusion densities and clinical measures of TRO. Results: Non-capillary peripapillary perfusion density in TRO eyes was found to be significantly decreased compared to healthy controls (TRO group 15.4 ± 2.9% vs controls 21.5 ± 3.1%; p < 0.0001). Capillary peripapillary perfusion densities showed no significant difference (TRO group 42.5 ± 1.8% vs controls 42.5 ± 1.5%; p = 1.0). Clinical measures of disease did not correlate well with OCT-A perfusion densities (p>0.05). Conclusion: These findings may represent decreased blood flow and subclinical ischemia to the optic nerve. We discuss possible pathogenic mechanisms of thyroid-related vasculopathy, including vessel wall thickening due to immunologically-induced media enlargement.

Original languageEnglish
Pages (from-to)867-875
Number of pages9
JournalClinical Ophthalmology
Volume16
DOIs
StatePublished - 2022
Externally publishedYes

Keywords

  • optical coherence tomography angiography
  • peripapillary microvasculature
  • thyroid-related orbitopathy
  • thyroid-related vasculopathy

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