Endocrine Abstracts

Introduction: Graves’ ophthalmopathy (GO) may develop nearly 25–50% in Graves’ Disease (GD). Clinical manifestations of GO are caused by the over compression of orbital tissues within the restricted orbital bone cavity. Impaired ocular blood flow may disrupt the retinal microstructure and functions. Early recognition of retinal and choroidal changes may alert the physicians for preventing ocular complications of GO. In this study we aimed to investigate the macular and choroidal thickness changes in GO compared with healthy subjects.

Materials and methods: The study group comprised 50 adult patients with previously diagnosed Graves’ Disease with ophthalmopathy who were on anti thyroid treatment, compared with controls. For the assessment of GO activity, VISA (vision, inflammation, strabismus, and appearance) inflammatory score was used. When euthryoidism was achieved without side effects, the patients were referred to the ophthalmology clinic for Spectral-domain optical coherence tomography (SD-OCT) evaluation. SD-OCT is a non-invasive method that is used for quantitive assessment of retinal morphology and choroidal thickness.

Results: Subfoveal, mean and temporal choroidal thicknesses were increased significantly in study group according to the controls. But nasal, peripapillary and choroidal thickness minimal increased in study group and there was no statistical difference. None of our patients had severe GO, and the mean intraocular pressure (IOP) was within the normal limits. However, the mean choroidal thickness was elevated.

Conclusions: We think that this elevation is because of the retroorbital inflammation even in this non-severe GO group. We also suggest that choroidal thickness might be affected from the venous obstruction and congestion in patients with GO. The elevation of the choroidal thickness might be an early sign of venous congestion that occurs before the elevation of IOP (Table 1).

This study has been presented as a poster (P176) at the 87th Annual Meeting of the American Thyroid Association. October 18–22, 2017. Victoria, BC, Canada.