Early macular and peripapillary vasculature dropout in active thyroid eye disease

To compare macular and peripapillary vasculatures in active thyroid eye disease (TED), not active not compressive (NANC) TED, and control eyes.

Twenty-one eyes of 12 active TED patients, 77 eyes of 43 NANC patients, and 65 eyes of 35 healthy normal subjects were recruited in this observational study. The participants underwent optical coherence tomography (OCT) and OCT angiography (OCT-A) of the peripapillary and macular areas. Macular ganglion cell complex (GCC) was measured in addition to peripapillary and macula superficial and deep vasculatures.

Linear mixed models accounting for inter-eye correlation showed that whole macular and parafoveal superficial vessel densities were significantly lower in the active TED with values of 50.6 ± 4.3% and 52.7 ± 4.8%, respectively, compared with control group values of 53.7 ± 3.0% and 56.3 ± 3.2% (P = 0.03, P < 0.001, respectively). In contrast, only the nasal sector of parafoveal vasculature value was significantly lower in the NANC TED than in control eyes (P = 0.03) and in the active group than in the NANC group (P < 0.001). Similarly, the average peripapillary vessel density was lower in the active TED than in the NANC and control groups. No significant differences were observed in GCC thickness among active, NANC, and control groups. Whole superficial macular and parafoveal vessel densities were significantly correlated with visual field MD (r = 0.32, r = 0.30, respectively, both P < 0.001).

OCT-A findings of lower peripapillary and macular vessel density values in the active TED eyes show subclinical retinal and optic nerve involvement.