Analysis of ocular parameters and clinical characteristics of patients with Graves' ophthalmopathy

Abstract

Purpose : To better understand the influencing factors related to Graves' ophthalmopathy (GO) activity degree and explore an effective predictive indicators for disease progression.

Methods : From June 2019 to December 2021, a total of 266 eyes were collected from 121 patients diagnosed with Graves' Ophthalmopathy (GO) at the Department of Endocrinology and Ophthalmology of the First Affiliated Hospital of Sun Yat-sen University. All patients underwent systematic and ophthalmic examination. Subsequently, the patients were categorized based on their clinical activity score (CAS) with GO at rest defined as CAS < 3 points and GO at active as CAS≥3 points. Comparative analysis of systemic and ocular parameters between the two groups was conducted. Receiver Operating Characteristic (ROC) curves were also generated to assess the diagnostic efficacy of each parameter for GO activity, with P values less than 0.05 deemed statistically significant.

Results : Among the included eyes, 166 eyes had inactive GO and 100 eyes had active GO. Both naked visual acuity and best corrected visual acuity in the active GO group were lower than those in the inactive GO group (0.6 vs. 0.8, P=0.019; 0.9 vs. 1.0, P=0.002). The mean ocular protrusion of patients in the active GO group was 20.5±1.5mm, higher than 18.5±2mm in the inactive GO group(P<0.001). The coefficient variation of cell area (CV) was significantly higher in active GO compared with inactive GO (36.3% vs. 34.05%, P=0.001). CAS score of the patients was demonstrated significant positive associations with age, diabetes mellitus, non-contact intraocular pressure, exophthalmia, deformation fraction, white blood cell number, neutrophil number, CD3+ cell number, thyrotrophin receptor antibody (r>0 and P<0.05), andsignificant negative correlations with naked eye acuity, interleukin-2, thyroid peroxidase antibody(TPO-Ab), free thyroxine, insulin-like growth factor 1 (IGF-1) and mean visual field defects (r<0 and P<0.05). Furthermore, the area under the ROC curve for thyroid peroxidase antibody (TPO-Ab) in predicting active GO was 0.723 (95%CI: 0.598 ~ 0.849), with 85.7% sensitivity and 62.5% specificity.

Conclusions : Active and inactive GO are with specific performance in whole body blood and eye parameters. Thyroid peroxidase antibody (TPO-Ab) level in GO patients can be used as an objective index for evaluating the activity status of GO.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.