甲状腺功能障碍视神经病变视网膜结构和微循环改变：一项全面的OCTA研究。

IF 7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology Pub Date : 2026-05-01 Epub Date: 2026-03-14 DOI:10.1016/j.apjo.2026.100303

Kexin Tan , Yan Liu , Yutong Zhang , Xiaochen Chen , Jipeng Li , Hui Wang , Shuo Wu , Ming Feng , Chenyue Xi , Qiuting Sun , Jing Sun , Yinwei Li , Zhangsheng Yu , Huifang Zhou , Xianqun Fan

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引用次数: 0

摘要

目的：研究甲状腺功能障碍视神经病变（DON）患者黄斑和视神经头（ONH）区视网膜结构和血管密度（VD）的改变，并评价其与视觉功能的相关性。方法：选取甲状腺眼病（TED）患者133例（有DON者63例，无DON者70例）和健康对照24例。采用光学相干断层扫描血管造影（OCTA）对黄斑（6 × 6mm）和ONH （4 × 4mm）区域的视网膜结构和血管参数进行量化。通过最佳矫正视力（BCVA）、视野（VF）和视觉诱发电位评估TED患者的视觉功能。采用受试者工作特征曲线下面积（AUC）评价OCTA参数对DON的诊断性能。结果：与非DON患者相比，DON患者黄斑区和ONH区视网膜VD均明显降低，黄斑视网膜变薄。黄斑全视网膜层（WRL）和浅视网膜层VD变化最明显（P < 0.001）。视网膜VD、厚度与BCVA、VF均值偏差均呈正相关。此外，黄斑WRL-VD对DON的诊断效能最高（AUC = 0.833），组合参数进一步提高了准确率（AUC = 0.861）。结论：OCTA显示DON视网膜微血管和结构改变，可作为一种简单、精确、无创的早期发现和临床治疗工具，预防不可逆的视力丧失。

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Retinal structure and microcirculation alterations in dysthyroid optic neuropathy: A comprehensive OCTA study

Purpose

This study aims to investigate retinal structure and vessel density (VD) alterations in the macular and optic nerve head (ONH) regions of patients with dysthyroid optic neuropathy (DON), and to assess their correlation with visual function.

Methods

A total of 133 thyroid eye disease (TED) patients (63 with DON and 70 without DON) and 24 healthy controls were enrolled. Retinal structural and vascular parameters were quantified using optical coherence tomography angiography (OCTA) in the macular (6 × 6 mm) and ONH (4 × 4 mm) regions. Visual function in TED patients was assessed by best corrected visual acuity (BCVA), visual field (VF), and visual evoked potentials. The diagnostic performance of OCTA parameters for identifying DON was evaluated using the area under the receiver operating characteristic curve (AUC).

Results

Compared with the non-DON patients, those with DON exhibited significantly decreased retinal VD in both macular and ONH regions, accompanied by thinner macular retina. The most pronounced changes were observed in macular whole retinal layer (WRL) and superficial retinal layer VD (P < 0.001). Both retinal VD and thickness correlated positively with BCVA and VF mean deviation. Furthermore, the macular WRL-VD demonstrated the highest diagnostic performance for DON (AUC = 0.833) and the combination parameters further improved accuracy (AUC = 0.861).

Conclusions

OCTA reveals retinal microvascular and structural alterations in DON and may serve as a simple, precise, and noninvasive tool for early detection and clinical management to prevent irreversible visual loss.

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来源期刊

Asia-Pacific Journal of Ophthalmology OPHTHALMOLOGY-

CiteScore

8.10

自引率

18.20%

发文量

197

审稿时长

6 weeks

期刊介绍： The Asia-Pacific Journal of Ophthalmology, a bimonthly, peer-reviewed online scientific publication, is an official publication of the Asia-Pacific Academy of Ophthalmology (APAO), a supranational organization which is committed to research, training, learning, publication and knowledge and skill transfers in ophthalmology and visual sciences. The Asia-Pacific Journal of Ophthalmology welcomes review articles on currently hot topics, original, previously unpublished manuscripts describing clinical investigations, clinical observations and clinically relevant laboratory investigations, as well as .perspectives containing personal viewpoints on topics with broad interests. Editorials are published by invitation only. Case reports are generally not considered. The Asia-Pacific Journal of Ophthalmology covers 16 subspecialties and is freely circulated among individual members of the APAO’s member societies, which amounts to a potential readership of over 50,000.