https://doi.org/10.31288/oftalmolzh201423743

Condition of the macula in patients with endocrine ophthalmopathology according to optical coherent tomography

S. I. Polyakova, E. V. Ivanitskaya, A. Kajali

State Institution The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine, Odessa, (Ukraine)

Introduction. Endocrine ophthalmopathology (EOP) is a progressing chronic disease of the soft tissues of the orbit and eye, developing against the background of the thyroid dysfunction with the unfavorable visual and cosmetic outcome, affecting work able at the age of35—59.

Purpose. To investigate a condition of the retina of the macular area in patients with EOP according to the data of optical coherent tomography.

Material and methods. Optical coherent tomography (OCT) was made in 103 eyes of 55 patients with EOP by the device « Stratus OCT model 3000 of the firm «Karl Zeis». The results obtained were compared to the data of examination of 69 eyes without ophthalmopathology. The analysis of the data is made with the use of the program Statistics 9.0.

Results and their discussion. It was established by OCT that average thickness of the retina in the fovea of the patients with EOP has made (212.8+32.9) pm that was by 18.3pm higher than in the norm (194.5+22.22) pm. The average thickness of the retina around the fovea varied depending on the direction of measurement and was higher than in the norm in all zones and sectors of measurement. Thickness of the macular area of the retina both in the internal and external zones of the investigation in all sectors was authentically higher than in the central one (p <0.0000), it was higher in the internal zone than in the external one. In comparison of the data of thickness of the retina in the upper and lower as well as nasal and temporal sectors it is established that thickness of the retina from the nasal side is authentically higher than with from the temporal one both in the three-millimetric (p <0.01) and in six-millimetric (p <0.0000) zones and it is practically identical in the upper and lower sectors (0.05). By means of OCT it was possible to reveal preclinical manifestation of retinal edema in the macular area in 45.5 % of cases, to administer adequate treatment and receive good result.

Conclusions. OCT should be included in the protocol of examination of patients, with EOP as an obligatory method of the investigation as it allows to reveal the initial stage of edema even in absence of clinical manifestations. 

Key words: endocrine ophthalmopathy 0ptical Coherence tomography, thickness of the macular retina

References

1.Brovkina AF. Endocrine ophthalmopathy. M.:GOETAR; 2004.174 p.

2.Brovkina AF, Gusev GA, Panteleeva OG. Optic neuropathy in patients with edematous exophthalmos. RMZh, Klin-icheskaia oftalmologiia. 2000;1(12):41-2. Russian.

3.Brovkina AF, Pavlova TL. Endocrine ophthalmopathy from position of ophthalmologist and endocrinologist. Klin Oftalmol. 2000;1:11-4. Russian.

4.Brovkina AF, Tolstukhina TL, Aleksandrova GF, Koto-va GA. Grave's euthyroid disease (Problems of diagnosis and treatment). Vestn Oftalmol. 2001;4:34-6. Russian.

5.Korol AR. The system of differential diagnosis and treat¬ment of exudative age-related macular degeneration: the¬sis of Doctor of Med. Science. 14.01.18. Ophthalmology. Odessa. 2014. 325 p.

6.Naumenko VA. System of a differentiated approach to the early diagnosis and treatment of eye pathology in diabetes: thesis of Doctor of Med. Science. 14.01.18. Ophthalmol¬ogy. Odessa. 2010. 287 p.

7.Panteleeva OG. The modern concept of the mechanism of development of the visual functions disorders in endocrine ophthalmopathy: thesis of Candidate of Med. Science. 14.00.08. Eye diseases. M. 2007. 168 p.

8.Chudnyavtsev SA. Prediction of post contusion degenera¬tive changes of the retina and optic nerve: thesis of Candi¬date of Med. Science. 14.01.18. Ophthalmology. Odessa. 2009. 110 p.

9.Acaroglu G, Simsek T, Ozalp S, Mutluay A. Subclinical op-tic neuropathy in Graves' orbitopathy. Jpn. J. Ophthalmol. 2003;47(5):459-62.
Crossref

10.An infant case of Graves' disease with ophthalmopathy / Kubo T., Shimizu J., Furujo M. [et al] // Endocr. J. —2005.— Vol. 52. — № 5. — P. 647-650.
Crossref

11.De Marco R, Ambrosio G, Ferrara G. Measuring con¬trast sensitivity in patients with Graves' ophthalmopathy complicated by ocular hypertension and suspect glau¬coma or dysthyroid optic neuropathy. Doc. Ophthalmol. 2000;101(2):165-77.

12.Kanamori A, Nakamura M, Escano MF et al. Evaluation of the glaucomatous damage on retinal nerve fiber layer thickness measured by optical coherence tomography. Am. J. Ophthalmol. 2003;135(4):513-20.
Crossref

13.Higashide T, Sugiyama K. Optical coherence tomography characteristics of a hemorrhagic detachment of the retinal pigment epithelium after blunt trauma. Am. J. Ophthalmol. 2003;136(3):567-9.
Crossref

14.Jaffe GJ, Caprioli J. Optical coherence tomography to detect and manage retinal disease and glaucoma. Am. J. Ophthalmol. 2004;137(1):156-69.
Crossref

15.Kahaly GJ. Imaging in thyroid-associated orbitopathy. Eur. J. Endocrinol. 2001;145(2):107- 18.
Crossref

16.Kahaly GJ. Recent developments in Graves' ophthalmop¬athy imaging. J. Endocrinol. Invest. 2004;27(3):254- 8.
Crossref

17.Karandish A, Wirbelauer C, Haberle H, Pham DT. Repro¬ducibility of goniometry with slitlamp-adapted optical co-herence tomography. Ophthalmologe. 2004;101(6):608-13.

18.Lane CM, Boschi A. Management of very several Graves' orbitopathy (Disthyroid optic neuropathy). Inbook: Graves' orbitopathy. A multidisciplinary approach. Ed. Wiersinga WM, Kahaly GJ. Karger. 2007. 153- 9.
Crossref

19.Gotzinger E, Pircher M, Sticker M et al. Measurement and imaging of birefringent properties of the human cor¬nea with phase-resolved, polarization-sensitive optical coherence tomography. J. Biomed. Opt. 2004; 9(1):94-102.
Crossref

20.Mrugacz M, Bakunowicz-Lazarczyk A. Optical coherence tomography in diagnosis of retinal diseases in children and adolescents. Klin. Oczna. 2004;106(1-2):115-8.

21.Wollstein G, Schuman JS, Price LL et al. Optical coher¬ence tomography (OCT) macular and peripapillary reti¬nal nerve fiber layer measurements and automated visual fields. Am. J. Ophthalmol. 2004;138(2):218-25.

22.Poonyathalang A, Preechawat P, Laothammatat J, Cha-ruratana O. Four recti enlargement at orbital apex and thyroid associated optic neuropathy. J. Med. Assoc. Thai. 2006;89(4):468-72.

23.Yoshida A, Feke GT, Mori F. Reproducibility and clinical application of a newly developed stabilized retinal laser Dop¬pler instrument. Am. J. Ophthalmol. 2003;135(3):356- 61. 

24.Robert PV, Camezind P, Adenis JP. Complications de l'ophtalmopathie  dysthyroidienne.  J.   Fr. Ophtalmol. 2004;27(7):819-21.

25.Varga M. Visual evoked potentials and ultrasonography in ischemic optic  neuropathy. Oftalmologia. 2002;53(2):41-5.

26.Wiersinga WM. Quality of life / In book: Graves' orbitopathy. A multidisciplinary approach. Ed. Wiersinga WM, Kahaly GJ, Karger, 2007. 201-11.

27.Yanik B, Conkbayir I, Acaroglu G, Hekimoglu B. Graves' ophthalmopathy: comparison of the Doppler sonography parameters with the clinical activity score. J. Clin. Ultra¬sound. 2005;33(8):375-80.

28.Zafar S, Gursesozden R, Makornwattana M et al. Scanning protocol choice affects optical coherence tomography (OCT-3) measurements. J. Glaucoma. 2004;13(2):142-4.