Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
Combined use of orbital soft tissue volume and retinal microvessel density for diagnosing dysthyroid optic neuropathy.
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Zhu Suhui, Lai Banghui, Wu Zhiyong, Fan Bin, Xiao Qian, Chen Xiaohu, Dai Yan
Аннотация
PURPOSE: To (i) detect changes in orbital soft tissue and retinal microstructure occurring in thyroid-associated ophthalmopathy (TAO), (ii) investigate the relationship between these variables and their bearing on visual impairment, and (iii) determine their combined diagnostic utility for dysthyroid optic neuropathy (DON).
METHODS: Enrolled in this retrospective study were patients with TAO eyes, which included the DON group, equivocal DON (eDON) and non-DON (nDON). Patients were divided into three experimental groups: DON (n = 18 eyes), eDON (n = 24 eyes), and nDON (n = 20 eyes). At the same time, a healthy control (C) group was included (n = 30 eyes). A three-dimensional (3D) volume index, obtained by reconstructing orbital soft tissue via computed tomography (CT) and Mimics software, was used. Optical coherence tomography angiography (OCT-A) was used to monitor and record retinal microstructural properties, i.e., microvessel density and thickness.
RESULTS: The DON group had significantly lower density and thickness of the retinal vasculature compared to the other groups (p < 0.05), with the exception of deep macular capillary density (MDRCP-VD), which was not statistically significant. In terms of soft-tissue volumes, the DON group had considerably higher orbital fat (OFV/BOV) and extraocular muscle indices (EOMV/BOV) than did the other groups; in contrast, the muscle cone inner volume index (MCIV/BOV) was lower (p < 0.05). A combination of the macular superficial retinal capillary plexuses (MSCRP-VD), optic nerve head vessel density-whole images (ONH-wiVD), MCIV/BOV, and EOMV/BOV yielded the highest values (AUC: 0.954, sensitivity: 95%, specificity: 88.1%) for the diagnosis of DON compared to the other groups.
CONCLUSIONS: EOMV/BOV plus MCIV/BOV, combined with MSRPC-VD plus ONH-wiVD, appears to provide the most accurate diagnostic guideline for DON. Further, 3D reconstructions of orbital soft tissue, in conjunction with OCT-A images, offer an innovative approach not only for preventing permanent loss of vision but also for enhancing the accuracy of diagnosing DON and its early stages.
METHODS: Enrolled in this retrospective study were patients with TAO eyes, which included the DON group, equivocal DON (eDON) and non-DON (nDON). Patients were divided into three experimental groups: DON (n = 18 eyes), eDON (n = 24 eyes), and nDON (n = 20 eyes). At the same time, a healthy control (C) group was included (n = 30 eyes). A three-dimensional (3D) volume index, obtained by reconstructing orbital soft tissue via computed tomography (CT) and Mimics software, was used. Optical coherence tomography angiography (OCT-A) was used to monitor and record retinal microstructural properties, i.e., microvessel density and thickness.
RESULTS: The DON group had significantly lower density and thickness of the retinal vasculature compared to the other groups (p < 0.05), with the exception of deep macular capillary density (MDRCP-VD), which was not statistically significant. In terms of soft-tissue volumes, the DON group had considerably higher orbital fat (OFV/BOV) and extraocular muscle indices (EOMV/BOV) than did the other groups; in contrast, the muscle cone inner volume index (MCIV/BOV) was lower (p < 0.05). A combination of the macular superficial retinal capillary plexuses (MSCRP-VD), optic nerve head vessel density-whole images (ONH-wiVD), MCIV/BOV, and EOMV/BOV yielded the highest values (AUC: 0.954, sensitivity: 95%, specificity: 88.1%) for the diagnosis of DON compared to the other groups.
CONCLUSIONS: EOMV/BOV plus MCIV/BOV, combined with MSRPC-VD plus ONH-wiVD, appears to provide the most accurate diagnostic guideline for DON. Further, 3D reconstructions of orbital soft tissue, in conjunction with OCT-A images, offer an innovative approach not only for preventing permanent loss of vision but also for enhancing the accuracy of diagnosing DON and its early stages.