Orbital and ocular perfusion in thyroid eye disease

Area of Science:

• Ophthalmology
• Endocrinology
• Medical Imaging

Background:

• Thyroid eye disease (TED) involves orbital changes like muscle enlargement and fat increase, potentially causing vision loss.
• Orbital congestion in TED compromises blood flow, leading to irreversible visual acuity reduction if untreated.
• Assessing orbital perfusion is crucial for managing TED progression and visual outcomes.

Purpose of the Study:

• To evaluate the role of hemodynamic changes in Thyroid eye disease (TED).
• To correlate orbital blood flow parameters with TED activity and dysthyroid optic neuropathy.
• To assess the impact of orbital decompression on orbital hemodynamics.

Main Methods:

• Color Doppler imaging to measure blood flow velocities in the superior ophthalmic vein (SOV) and arteries (OA, CRA).
• Optical coherence tomography (OCT) and OCT angiography to study retinal and choroidal microvasculature.
• Quantitative assessment of orbital perfusion and hemodynamic fluctuations during TED.

Main Results:

• Orbital congestion in TED correlates with reduced SOV flow and increased choroidal thickness.
• Active TED phases show high blood flow velocities in OA and CRA.
• Dysthyroid optic neuropathy onset is linked to reduced arterial perfusion and vascular density.

Conclusions:

• Orbital hemodynamic monitoring aids in understanding TED progression and activity.
• Changes in SOV flow and arterial resistivity index reflect disease status.
• Sequential hemodynamic evaluation can guide treatment planning and intervention in TED.