Abstract
Purpose :
Thyroid eye disease (TED) is one of the most common and serious extra-thyroidal manifestations of Graves’ disease. This study evaluated the use of optical coherence tomography (OCT) for detecting changes in muscle-tendon complex thickness and subfoveal choroidal thickness in patients affected by TED in a clinical setting.
Methods :
A prospective cross-sectional study of 46 eyes from 13 TED patients and 10 healthy controls was performed. Anterior segment OCT (AS-OCT) was used to measure the lateral rectus (LR), medial rectus (MR), inferior rectus (IR), and superior rectus (SR) muscle-tendon complex thicknesses of each eye in patients with TED and healthy controls. In addition, OCT was used to measure subfoveal choroidal thickness in all subjects. A two-tailed T-test was used to evaluate for statistical significance.
Results :
The mean muscle-tendon complex thickness of the MR and LR (mean of OD and OS) was significantly greater in TED subjects (300.8 μm ± 19.2 SE and 319.6 μm ± 16.0 SE) compared to healthy controls (206.5 μm ± 10.3 SE; p=0.00 and 199.7 μm ± 10.6 SE; p=0.00). The mean thickness of the SR and IR was also significantly greater in TED patients (305.8 ± 44.7 SE and 276.3 μm ± 23.0 SE) than controls (134.3 μm ± 14.9 SE; p=0.003 and 189.3μm ± 12.0 SE; p=0.003). Combined choroidal thickness measurements were not significantly different between TED patients and controls (p>0.05); however, left choroidal thickness was significantly greater in TED patients with a clinical activity score (CAS) greater than 1 (300.5 μm ± 1.7 SE) compared to controls (262 μm ± 13.5 SE; p=0.040) and TED patients with a CAS of 1 or less (263 μm ± 12.0 SE; p=0.018).
Conclusions :
To our knowledge, this is one of the first studies of its kind in the United States to demonstrate that AS-OCT can detect an increased horizontal and vertical muscle-tendon complex thickness in TED. Futher, OCT measurement of subfoveal choroidal thickness did not significantly differ between TED and control patients; however, the left choroid was significantly thicker in patients with a CAS greater than 1 compared to controls and TED patients with a CAS of 1 or less. With further validation, OCT may be an invaluable tool for clinicians to diagnose, stage, and monitor TED.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.