Retinal structure and microcirculation alterations in dysthyroid optic neuropathy: A comprehensive OCTA study.

Area of Science:

• Ophthalmology
• Medical Imaging
• Neuro-ophthalmology

Background:

• Thyroid eye disease (TED) can lead to dysthyroid optic neuropathy (DON), causing vision impairment.
• Assessing microvascular and structural changes in DON is crucial for early detection.

Purpose of the Study:

• To investigate retinal structure and vessel density (VD) alterations in macular and optic nerve head (ONH) regions in DON patients.
• To correlate these changes with visual function.
• To evaluate OCTA's diagnostic performance for DON.

Main Methods:

• 133 TED patients (63 DON, 70 non-DON) and 24 controls underwent OCTA.
• Macular and ONH regions were scanned for retinal structural and vascular parameters.
• Visual function was assessed using BCVA, VF, and VEPs.

Main Results:

• DON patients showed significantly decreased macular and ONH retinal VD and thinner maculas compared to non-DON patients.
• Macular whole retinal layer (WRL) and superficial retinal layer VD were most affected.
• Retinal VD and thickness positively correlated with BCVA and VF mean deviation.

Conclusions:

• OCTA effectively identifies microvascular and structural retinal changes in DON.
• OCTA serves as a precise, noninvasive tool for early DON detection and management.
• Early detection can help prevent irreversible visual loss.