| Objective: The objective of study is to observe the changes of central macular choroidal thickness(CMCT)and to compare the differences in the central macular choroidal thickness(CMCT)between thyroid-associated ophthalmopathy(TAO)patients in active and inactive stages,and healthy subjects using spectral-domain optical coherence tomography(SD-OCT)and to assess whether central macular choroid thickness(CMCT)can be a new assessment index for TAO patients' activity,diagnosis,prognosis,and follow-up.Methods: Cross-sectional study.A total of 30 patients with a previous diagnosis of thyroid-associated ophthalmopathy(TAO)and 30 age-,gender-,and diopter-levelmatched healthy participants who attended The first affiliated Hospital of Dalian Medical University from September 2018 to March 2020 were evaluated.Collect and record their basic information,laboratory tests and results of ophthalmological examinations.The clinical activity score(CAS)system was used to assess the activity of TAO patients.The subjects were divided into three groups,the first group: active TAO group(5 males,6 females,mean age 43 ±11 years);the second group: inactive TAO group,(5 males,14 females,mean age 43 ±15 years);the third group: healthy control group(15 males,15 females,mean age 46 ±10 years).All subjects underwent comprehensive ophthalmological examinations,including best correct visual acuity(BCVA)(International Standard Log Vision Chart),intraocular pressure measurement(IOP)(Goldmann applanation tonometer),diopter measurement(Automatic optometer),anterior segment examination(Slit lamp microscope),posterior segment examination(Direct fundus examination),A-scan axial measurement(Biometrics),exophthalmos measurement(Hertel exophthalmometer),central macular choroidal thickness(CMCT)(SD-OCT).A scan centered on the macular fovea was performed in all participants using the SD-OCT.The CMCT was measured.Statistical analysis was performed using SPSS 25.0.The variance analysis method was used to analyze the differences of CMCT,CAS,IOP,exophthalmos,and other detection indicators.The univariate linear regression and multivariate linear regression were used to analyze the correlation between the detection indicators and CMCT.Results: In the first group,the mean CMCT was(390.54±4.87)?m,the mean CAS was(4.36±1.29)points,the mean IOP was(21.73±1.74)mm Hg,and the mean exophthalmos was(19.82±2.44)mm.In the second group,the mean CMCT was(316.16±4.94)?m,the mean CAS was(0.96±0.78)points,the mean IOP was(16.63±1.46)mm Hg,the mean exophthalmos was(15.61 ±1.50)mm.In the third group,the mean CMCT was(314.47±2.97)?m,the mean IOP was(15.83±51.39)mm Hg,the mean exophthalmos was(12.82±1.00)mm.The CMCT in active TAO qgroup was significantly higher than that in inactive TAO group and healthy control group(P< 0.001),but there was no significant difference between inactive TAO group and healthy control group(P>0.05).The IOP in active TAO group was significantly higher than that in inactive TAO group and healthy control group(P< 0.001),but there was no significant difference between inactive TAO group and healthy control group(P=0.071).The exophthalmos in active TAO group was significantly higher than that in inactive TAO group and healthy control group(P<0.001),and there was also significant difference between inactive TAO group and healthy control group(P< 0.001).In univariate analysis,CMCT was positively correlated with IOP(t=11.586,P<0.001).After adjusting IOP,CMCT were positively correlated with CAS(t=15.715,P<0.001),and exophthalmos(t=8.851,P<0.001),but there were no correlation with sex,age,BCVA,axial length and thyroid function(all P>0 05).In multivariate analysis,taking CMCT as dependent variable and other parameters as independent variables,it was found that CMCT was also positively correlated with CAS(t=7.182,P<0.001)and IOP(t=3.382,P<0.001),but there was no correlation with exophthalmos(t=1.134,P=0.261).Conclusion: The CMCT of patients in active TAO group is higher than that in inactive TAO group and in healthy control group,and there is a positive correlation between CMCT and CAS.The examination of CMCT has a certain reference value in evaluating the activity of patients with TAO,and can be used as a new evaluation index for diagnosis,prognosis and follow-up of patients with TAO. |
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