Evaluation of Retinal Neurodegeneration and Choroidal Thickness in Patients with Inactive Graves' Ophthalmopathy.

PURPOSE: The study was conducted for the assessment of the retinal nerve fiber layer, ganglion cell layer, and subfoveal choroidal thickness changes in patients with inactive Graves' ophthalmopathy (GO) using swept-source optical coherence tomography (SS-OCT) before the development of active GO findings. MATERIALS AND METHODS: The cross-sectional designed study consisted of patients with inactive Graves' ophthalmopathy (study group) and healthy subjects (control group). The thicknesses of the retinal ganglion cell layer, retinal nerve fiber layer, and subfoveal choroid (SFCT) were measured using SS-OCT with deep range imaging technology to compare these parameters between the study and control groups. RESULT: Patients with inactive Graves' ophthalmopathy had higher values of intraocular pressure but similar best-corrected visual acuity (p = 0.001, p = 0.232, respectively). The retinal nerve fiber layer was thinner only in the superior zone of the study group (p = 0.039), whereas similar values were noted in the temporal, nasal, and inferior areas as well as the average thickness. We did not observe any statistically significant difference in any sector of the ganglion cell layer between the study and control groups. A thicker mean subfoveal choroidal thickness value was measured in patients with inactive Graves' ophthalmopathy than in healthy subjects (p = 0.013) in correlation with a clinical activity score (p = 0.046). CONCLUSION: SS-OCT showed minimal retinal neurodegenerative alteration and significant choroidal thickening in inactive GO. Thus, SS-OCT might be a beneficial technique to detect retinal neurodegenerative and choroidal changes earlier in the stage of inactive GO before the development of active GO signs, which may affect the time and type of treatment modalities to prevent further ocular or systemic complications. Additionally, SFCT may be a good indicator for assessment of the severity of Graves' disease.

Analysis of retinal neurodegeneration in gestational and type 2 diabetes using swept-source optical coherence tomography.

OBJECTIVE: This study aimed to compare the retina and choroid thickness in age-matched pregnant individuals with gestational diabetes mellitus, nonpregnant diabetic females, and healthy nonpregnant females. METHOD: This cross-sectional study included 2 study groups, 1 composed of pregnant women with gestational diabetes mellitus and 1 consisting of nonpregnant type 2 diabetic patients without diabetic retinopathy, and a control group of healthy nonpregnant subjects. Swept-source optical coherence tomography was used to measure the retinal and choroidal thickness. The measurements were compared between the study groups and between the study groups and the control group. RESULTS: All groups had similar mean ages, best-corrected visual acuity, and intraocular pressure (p = 0.122, p = 0.158, and p = 0.186, respectively). The mean central macular thickness of the gestational diabetes, type 2 diabetes, and control groups was 215.3 ± 10.83, 220.58 ± 21.62, and 230.03 ± 21.24 µm, respectively (p = 0.002). The retinal nerve fibre layer was slightly thinner only in the inferior zone of the study groups (p = 0.058) compared with the control group. We observed statistically significant differences in the thickness of all sectors of the ganglion cell layer between all groups (all p < 0.05), with the nonpregnant type 2 diabetic group exhibiting the lowest values. A similar mean subfoveal choroidal thickness was observed in all 3 groups (p = 0.247). CONCLUSION: Swept-source optical coherence tomography plays an important role in detecting retinal neurodegenerative changes and choroidal thickness induced by gestational and type 2 diabetes before the development of diabetic retinopathy.

Analysis of Foveal and Parafoveal Microvascular Density and Retinal Vessel Caliber Alteration in Inactive Graves' Ophthalmopathy.

PURPOSE: We aimed to evaluate foveal and parafoveal density using optical coherence tomography angiography and the alteration on the retinal vessel diameter in patients with inactive Graves' ophthalmopathy compared to age-matched normal population. Materials and Methods. Patients with inactive Graves' ophthalmopathy (study group) and healthy individuals (control group) were enrolled in the cross sectionally designed study. The optical coherence tomography angiography parameters and retinal vessel diameter measurements were assessed between the study and control groups. Foveal and parafoveal microvascular density in the retina was measured using optical coherence tomography angiography. Retinal artery and vein diameter and artery/vein ratio were assessed for retinal vessel caliber changes. RESULTS: Patients with inactive Graves' ophthalmopathy had higher values of intraocular pressure, proptosis, and axial length (P=0.001, P=0.001, P=0.001, P=0.001, P=0.001, P=0.001, P=0.001, P=0.001, P=0.001, P=0.001, P=0.001. CONCLUSION: Optical coherence tomography angiography could be a novel and promising noninvasive diagnostic technique in patients with inactive Graves' ophthalmopathy to detect foveal and parafoveal vessel density changes compared to healthy subjects. The decrease of retinal vessel diameter might be observed in patients with inactive graves ophthalmopathy.

The effect of topical cyclosporine A treatment on corneal thickness in patients with trachomatous dry eye.

PURPOSE: The purpose of the present study was to evaluate the effect of topical cyclosporine A (CsA) treatment on corneal thickness (CT) in patients with trachomatous dry eye. METHODS: Sixty-four patients with trachomatous dry eye with a Schirmer test showing 5 mm or less and a tear film break-up time (TFBUT) of five seconds or less were included. Thirty-two patients were treated with twice daily application of CsA (0.05% ophthalmic emulsion) plus non-preserved artificial tears, while the remaining 32 patients serving as controls received only non-preserved artificial tears. CT was measured using ultrasonic pachymetry at five locations of the central (CCT) and mid-peripheral cornea, at baseline and after one, three and six months of treatment. RESULTS: At the sixth month of treatment, CT measurements were significantly changed in both groups, compared to baseline. In the CsA treatment group, the mean CCT before and after six months of treatment were 517.4 +/- 36.2 and 546.5 +/- 32.4 microm, respectively (p < 0.001); yielding an average CCT increase of 29.1 +/- 8.0 microm (5.62 per cent) from baseline. In the control group, corresponding figures were 520.2 +/- 34.2 and 526.0 +/- 35.4 microm, respectively (p < 0.01), with an average increase of 5.8 +/- 3.1 microm (1.11 per cent). CONCLUSIONS: In the present study, the CsA treatment group exhibited significantly greater increases in CT compared to controls. Such an increase may indicate an improvement in the integrity of the ocular surface and resolution of the underlying inflammation as a consequence of topical CsA treatment.