| Objective:To evaluate the blood flow of patients with thyroid-associated ophthalmopathy and its correlation with visual function by optical coherence tomography.Method :Case-control study.Twenty-nine patients with moderate to severe TAO who came to our hospital from December 2019 to December 2020 were selected,and 14 healthy subjects who received physical examination during the same period were selected as the control group.Among them,the moderate to severe TAO patients were divided into 15 cases in the active phase group and 14 cases in the stationary phase group according to the CAS score.All subjects underwent best-corrected visual acuity(BCVA),intraocular pressure,eye axis,eyeball protrusion,visual field examination,and optical coherence tomography to measure the retinal nerve fiber layer(RNFL)and retinal ganglion cell complex(GCC)Average thickness;use OCTA to measure superficial macular vascular density(VD),vascular perfusion density(PD),foveal avascular zone(FAZ)perimeter,FAZ area,of which macular Regional blood vessel density can be divided into center,inner layer,and whole part.The inner blood vessel part can also be subdivided into four parts: upper,lower,nasal,and temporal.The differences in VD,PD,and FAZ parameters of the superficial macular between the three groups and the correlation between gender,age,eye axis,eye protrusion and visual function parameters were analyzed.One-way analysis of variance,Krusal-will nonparametric test,Bonferroni post-hoc analysis and Spearman correlation analysis were used to analyze the differences between the data.Result:The difference in the degree of exophthalmos between TAO active period group17.00(16.00,20.50),TAO resting period group 15(14,15.5)and healthy control group 14.00(13.50,15.00)was statistically significant(X2=21.476,P=0.000)).There were no significant differences in gender,age,axis of eyes,BCVA,intraocular pressure,axis of eyes,MD,PSD,RNFL,GCC average thickness,FAZ circumference,and FAZ area in the 3 groups(P>0.05).VD: VD in the center of the superficial macular area(5.90±0.63),inner layer(19.61±1.92),overall(18.54±1.47),lower19.65(18.40,21.0),and temporal(18.72±2.09)in the TAO stationary phase group In the TAO active period group(9.47±2.77),(21.44±1.66),(20.28±1.63),21.50(20.2,22.40),(21.25±1.75)and normal control group(8.10±2.63),(21.30±1.10),(19.94±1.10),21.30(20.7,21.9),(20.84±1.26)The difference was statistically significant(P=0.000,P=0.006,P=0.005,P=0.013,P=0.001).PD: 0.108(0.104,0.119)in the center of the superficial macular area in the TAO quiescent group,the inner macular area(0.361±0.02),the entire macular area 0.344(0.331,0.349),inferior(0.360±0.024),temporal side(0.348 ± 0.039)PD was lower than 0.165(0.154,0.196),(0.385 ±0.03),0.363(0.333,0.387),(0.385 ± 0.028),(0.386± 0.029)in the TAO active phase group and 0.157(0.117,0.172)in the normal control group),(0.381±0.02),0.363(0.352,0.368),(0.383 ± 0.027),(0.377 ± 0.025),the difference was statistically significant(P=0.000,P=0.023,P=0.012,P=0.019,P= 0.008).Correlation analysis: The overall superficial PD(r=0.592,p=0.02)of the macular area in the active TAO group was positively correlated with the degree of eyeball protrusion.Active group(r=0.666,p=0.007),(r=0.558,p=0.031),stationary group(r=0.645,p=0.013),(r=0.562,p=0.036)and healthy control group FAZ Circumference(r=+0.551,p=0.041)and FAZ area(r=+0.692,P=0.006)are related to gender.Female FAZ perimeter and FAZ area are higher than males.The overall VD of the macular in women in the healthy group was higher than that in men(r=+0.622,p=0.018).The three groups of superficial macular blood flow density,FAZ circumference,FAZ area have no correlation with the average thickness of BCVA,MD,PSD,RNFL and GCC(P>0.05).Conclusion:1.In patients with moderate to severe TAO,the density of superficial blood vessels in the macular area decreases.2.OCTA can further monitor the disease process by observing TAO blood vessel density,which can help us improve Explain the pathophysiological process of TAO well. |
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