Retinal and Optic-Disc Changes Associated With ¹³¹I Therapy in Papillary Thyroid Carcinoma and Their Determinants

This study aimed to evaluate retinal and optic-disc changes in papillary thyroid carcinoma (PTC) following post-surgical radioactive iodine (¹³¹I) therapy and identify the factors influencing these changes.

This study enrolled 60 patients (120 eyes) who received ¹³¹I therapy after surgical removal of PTC. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) were used to evaluate the macular and optic-disc structures, and macular microcirculation before and 1 month after ¹³¹I therapy. The effects of ¹³¹I dose and pretreatment lymphocyte-subset levels on the differences were analyzed.

The superior outer ring of the macular region was thinner after ¹³¹I therapy than before (P < 0.05). The cup-to-disc ratio (CDR) was slightly increased (P < 0.001), whereas the thicknesses of the ganglion cell layer and retinal nerve fiber layer showed no significant changes (P > 0.05). Vessel density (VD) and perfusion density (PD) in the superficial choroidal vascular plexus were decreased (P < 0.05), especially in patients with high B-lymphocyte levels (P < 0.05). The VD and PD of the inner ring, outer ring, whole circle, and several sectoral regions decreased more in the 150 to 200 millicurie (mCi) group than in the <150 and >200 mCi groups. No significant linear associations were found among ¹³¹I dosage, baseline B-lymphocyte levels, age, or body mass index (BMI) and retinal microvascular changes (all P > 0.05).

After initial ¹³¹I therapy, patients with PTC exhibit short-term macular thinning, reduced blood flow, and a slight CDR increase, highlighting the need to monitor optic-disc changes. The ¹³¹I dosage and pretreatment B-lymphocyte levels may be associated with post-therapy retinal microcirculation; however, the relationship does not appear to follow a simple linear pattern.