Reduced Retinal Microvascular Density Related to Activity Status and Serum Antibodies in Patients with Graves’ Ophthalmopathy

ABSTRACT

Objective: To investigate changes in retinal capillary density (RCD) that occur in Graves’ ophthalmopathy (GO) and explore their association with the clinical manifestations for GO.

Material and Methods: A total of 125 participants (93 GO patients and 32 normal subjects) were enrolled. All participants underwent ophthalmology and endocrinology examinations. Retinal microvasculature was imaged by spectral domain optical coherence tomographic angiography (OCT-A). The RCDs in the superficial and deep retinal capillary plexuses (SRCP and DRCP) were quantified by the custom software from the OCT-A images, which were divided into total annular zones (TAZ) and four quadrants. Multiple linear regression analysis was used to explore the associations between RCD and the relevant factors.

Results: Significant reduction was seen in the TAZ zone in SRCP and DRCP of GO group (P < .05) when compared to the healthy subjects; significant differences remained after adjustment of vascular relevant factors. According to the univariate analysis, the relevant factors of higher IOP, larger proptosis, higher clinical activity scoring (CAS), thyroid stimulating hormone-receptor autoantibodies (TRAb), and ¹³¹I therapy were significantly associated with decreased RCDs in GO patients (P < .05). Multivariate linear regression analysis showed that CAS and TRAb were the most important relevant factors for decreased RCDs.

Conclusions: The RCD of GO patients was significantly decreased compared to the healthy controls. The activity status and serum antibodies associated with GO were the relevant factors for reduced RCD.

KEYWORDS:

• Retina
• microvasculature
• density
• optical coherence tomography angiography
• Graves’ ophthalmopathy

Acknowledgments

This study was supported by research grants from the Nature Science Foundation of Zhejiang Province (LY19H120003) and National Nature Science Foundation of China (81570880), the Public Service Program of Wenzhou Science and Technology Bureau of China (Y20160151), and the National Key Project of Research and Development Program of China (2016YFE0107000).

Contributions of each author

Design of the study (QC, MS, FL); Conduct of the study, data collection, analysis and interpretation (QC, YW, YT, LB, CW, JZ); Manuscript preparation and review (QC, MS, JW, FL).

Financial disclosures

The authors have no proprietary interest in any materials or methods described within this article.

Statement about conformity

The research review board of Wenzhou Medical University approved this study.

Other acknowledgement

We thank Dr. Britt Bromberg of Xenofile Editing (www.xenofileediting.com) and Dr. William Robert Kwapong for providing editing services for this manuscript.

Additional information

Funding

This study was supported by research grants from Natural Science Foundation of Zhejiang Province (LY19H120003) and National Nature Science Foundation of China (81570880).