Quantitative Analysis of Choroidal Thickness and Blood Flow in Thyroid-Associated Ophthalmopathy Using Ultra-Widefield Swept-Source OCT Angiography

IF 5 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2026-07-01 Epub Date: 2026-05-14 DOI:10.1016/j.xops.2026.101236

Guodong Liu MD, Kunhua Jiang MD, Mingyang Wang MD, Tianyu Zheng MD, PhD

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Abstract

Objective

To quantitatively analyze choroidal thickness and blood flow in thyroid-associated ophthalmopathy (TAO) using ultra-widefield swept-source OCT angiography (UWF SS-OCTA), and to characterize differences among dysthyroid optic neuropathy (DON), non-DON, and normal eyes.

Design

Retrospective cross-sectional study.

Subjects

The study included 65 eyes from 35 TAO patients (15 males, 20 females; mean age 51.8 ± 12.6 years), comprising 5 mild, 40 moderate-to-severe, and 20 DON eyes. A control group of 70 eyes from 38 age- and sex-matched healthy subjects (15 males, 23 females; mean age 52.8 ± 14.9 years) was also included.

Methods

Ultra-widefield SS-OCTA imaging was performed to capture data sets divided into 9 subfields. Automated segmentation was used to measure structural thickness (whole choroid, large-vessel choroidal layer) and vascular density (choriocapillaris, large-vessel choroidal layer). Parameters were compared between TAO and control eyes, and subgroup analyses were conducted between DON and non-DON eyes.

Main Outcome Measures

Choroidal thickness and vascular density in the whole choroid, choriocapillaris, and large-vessel choroidal layer across 9 subfields.

Results

Thyroid-associated ophthalmopathy eyes showed significantly greater whole choroidal thickness (189.9 ± 2.6 μm vs. 182.4 ± 2.3 μm, P < 0.001) and large-vessel choroidal layer thickness (161.4 ± 2.7 μm vs. 149.9 ± 2.3 μm, P < 0.0001) compared with controls, particularly in central and nasal regions. Vascular density was reduced in TAO eyes for the large-vessel choroidal layer (39.86 ± 0.25% vs. 40.54 ± 0.15%, P = 0.014) and showed a nonsignificant decrease in the choriocapillaris (47.57 ± 3.24% vs. 47.89 ± 0.12%, P = 0.067). Subgroup analysis revealed that these differences were primarily driven by DON eyes, whereas non-DON TAO eyes showed no significant changes compared with controls.

Conclusions

Ultra-widefield SS-OCTA effectively identifies choroidal changes in TAO, revealing increased thickness accompanied by reduced vascular density. These findings suggest that choroidal thickening is primarily due to stromal edema rather than vascular engorgement, particularly in DON eyes, highlighting the role of choroidal remodeling in TAO progression.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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超宽视场扫描源OCT血管造影定量分析甲状腺相关性眼病脉络膜厚度和血流。

目的：应用超宽视场扫描源OCT血管造影（uwfss - octa）定量分析甲状腺相关性眼病（TAO）的脉络膜厚度和血流，并表征甲状腺功能障碍视神经病变（DON）、非DON和正常眼的差异。设计：回顾性横断面研究。对象：本研究纳入35例TAO患者65只眼（男15只，女20只，平均年龄51.8±12.6岁），其中轻度5只，中重度40只，DON眼20只。对照组为年龄和性别匹配的38例健康受试者（男性15例，女性23例，平均年龄52.8±14.9岁）70只眼。方法：采用超宽视场SS-OCTA成像，采集数据集，分为9个子场。采用自动分割测量结构厚度（全脉络膜，大血管脉络膜层）和血管密度（脉络膜毛细血管，大血管脉络膜层）。比较TAO眼与对照眼的参数，并对DON眼与非DON眼进行亚组分析。主要观察指标：整个脉络膜、绒毛膜毛细血管和9个亚场的大血管脉络膜层的厚度和血管密度。结果：甲状腺相关性眼病患者的全脉络膜厚度（189.9±2.6 μm vs. 182.4±2.3 μm, P < 0.001）和大血管脉络膜层厚度（161.4±2.7 μm vs. 149.9±2.3 μm, P < 0.0001）明显高于对照组，特别是在中部和鼻区。TAO眼大血管脉络膜层血管密度降低（39.86±0.25%比40.54±0.15%,P = 0.014），脉络膜毛层血管密度降低（47.57±3.24%比47.89±0.12%,P = 0.067）。亚组分析显示，这些差异主要由DON眼睛驱动，而非DON TAO眼睛与对照组相比没有显着变化。结论：超宽视场SS-OCTA能有效识别TAO的脉络膜变化，显示血管厚度增加，同时血管密度降低。这些发现表明脉络膜增厚主要是由于间质水肿而不是血管充血，特别是在DON眼中，这突出了脉络膜重塑在TAO进展中的作用。财务披露：专有或商业披露可在本文末尾的脚注和披露中找到。

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