Investigation and Evaluation of Corneal Parameters in Patients withThyroid Ophthalmopathy

Evaluation of Corneal Parameters in Thyroid Ophthalmopathy

Authors

DOI:

https://doi.org/10.37609/srinmed.36

Keywords:

Thyroid ophthalmopathy, corneal densitometry, corneal topography

Abstract

Purpose: To evaluate corneal findings in patients with thyroid ophthalmopathy according to clinical activity score using corneal densitometry and corneal topography parameters.

Methods: This cross-sectional study was conducted in the department of Ophthalmology of Cukurova University between January 1, 2021, and June 31, 2022. The patients underwent a comprehensive ophthalmological examination, including best-corrected visual acuity, slit lamp biomicroscopy, intraocular pressure measurement with Goldmann applanation tonometry, fundoscopic examination and hertel exophthalmometry. Clinical activity scores according to the European Group of Graves' Orbitopathy (EUGOGO) classification  recorded. Corneal densitometry and topography data recorded for 3 months were noted and evaluated together according to the EUGOGO classification.

Results: Fifty eyes of 25 thyroid orbitopathy cases (15 female, 10 male) with a mean age of 52.6±12.87 years were included in the study. For corneal densitometric measurements in the first month of evaluation, there were significant differences in 2-6 mm zone specifically in anterior and posterior layers (p<0,040, p<0,010), 6-10 mm zone specifically in anterior, center, posterior layers and total diameter (p<0,008, p<0,002, p<0,002, p<0,003). When it comes to corneal topography, changes were detected in Sim K values especially a decrease in K1 and Avg in patients with mild and severe TO (p<0,046, p<0,010) and in patients with mild and moderate TO (p<0,027, p<0,017). 

Conclusion: Mechanical and inflammatory factors play a significant role in the ocular findings of TO and can change corneal biomechanical properties. The present study showed differences in corneal topography and densitometry parameters among the patients with thyroid ophthalmopathy.

References

Lee ACH, Kahaly GJ. Pathophysiology of thyroid-associated orbitopathy. Best Pract Res Clin Endocrinol Metab. 2022 Feb 5:101620. doi: 10.1016/j.beem.2022.101620. Epub ahead of print. PMID: 35181241.

Debnam JM, Koka K, Esmaeli B. Extrathyroidal Manifestations of Thyroid Disease: Graves Eye Disease. Neuroimaging Clin N Am. 2021;31(3):367-378. doi: 10.1016/j.nic.2021.04.006. PMID: 34243871.

Bartalena L, Kahaly GJ, Baldeschi L, Dayan CM, Eckstein A, Marcocci C, et al. The 2021 European Group on Graves' orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves' orbitopathy. Eur J Endocrinol. 2021;185(4):G43-G67. doi: 10.1530/EJE-21-0479. PMID: 34297684.

Blum Meirovitch S, Leibovitch I, Kesler A, Varssano D, Rosenblatt A, Neudorfer M. Retina and Nerve Fiber Layer Thickness in Eyes with Thyroid-Associated Ophthalmopathy. Isr Med Assoc J. 2017;19:277-281.

Lopes B, Ramos I, Ambrósio R Jr. Corneal densitometry in keratoconus. Cornea. 2014;33(12):1282-6. doi: 10.1097/ICO.0000000000000266. PMID: 25285589.

Carreira AR, Rodrigues-Barros S, Moraes F, Loureiro T, Machado I, Campos P, et al. Impact of Graves Disease on Ocular Surface and Corneal Epithelial Thickness in Patients With and Without Graves Orbitopathy. Cornea. 2022;41(4):443-449. doi:10.1097/ICO.0000000000002753. PMID: 34029245.

Yang X, Huang D, Ai S, Liang X, Zhao J, Fang L. Retinal Vessel Oxygen Saturation and Vessel Diameter in Inactive Graves Ophthalmopathy. Ophthal Plast Reconstr Surg. 2017;33:459-465.

Tran AQ, Zhou HW, Nanda T, Godfrey KJ, Tooley AA, North VS, Kazim M. Evolution of asymmetric proptosis during the active phase of thyroid eye disease. Orbit. 2023;42(2):251-255. doi: 10.1080/01676830.2022.2088807.

Luo L, Li D, Gao L, Wang W. Retinal nerve fiber layer and ganglion cell complex thickness as a diagnostic tool in early stage dysthyroid optic neuropathy. Eur J Ophthalmol 2022;32(5):3082-3091. doi: 10.1177/11206721211062030. Epub 2021 Dec 7. PMID: 34873954.

Hoang TD, Stocker DJ, Chou EL, Burch HB. 2022 update on clinical management of Graves disease and thyroid eye disease. Endocrinol Metabol Clin North Am 2022;51(2):287-304.

Weiler DL. Thyroid eye disease: a review. Clin Exp Optom. 2017;100(1):20-25.

Gonzalez-Garcia A, Sales-Sans M. Treatment of Graves’ ophthalmopathy. Med Clin 2021;156(4):180-186.

Hall AJH, Topliss DJ. Medical and surgical treatment of thyroid eye disease. Intern Med J 2022;51:14-20.

Wagner RS. Diagnosing and treating thyroid ophthalmopathy. J Pediatr Ophthalmol Strabismus 2018;55:355.

Bartalena L, Tanda ML. Current consepts regarding Graves’ orbitopathy. J Intern Med 2022;292:692-716.

Downloads

Published

2025-04-28

How to Cite

1.
Ulas B, Ozcan AA. Investigation and Evaluation of Corneal Parameters in Patients withThyroid Ophthalmopathy: Evaluation of Corneal Parameters in Thyroid Ophthalmopathy. SRINMED [Internet]. 2025 Apr. 28 [cited 2025 May 14];2(1):173-9. Available from: https://journals.akademisyen.net/index.php/srinmed/article/view/36

Issue

Section

Research Articles