Assessment of retinal and choroidal vessel density and nerve fibre layer thickness changes after orbitotomy in patients with severe non-active thyroid orbitopathy: a prospective study.

PURPOSE: To evaluate the optical coherence tomography angiogram changes in non-active severe thyroid-related ophthalmopathy patients after cosmetic bone decompression. METHODS: Eighteen patients (25 eyes) with severe not active not compressive (NANC) TED who were candidates for decompression surgery for cosmetic reasons were included in this study, and a 3 × 3 mm macular scan was used to measure vessel density and RNFL thickness. Whole macular vessel density in its superficial, deep and choriocapillaris layers was evaluated. The following data were extracted for each of layers: superior and inferior hemispheres, fovea, parafoveal vessel density, its superior and inferior hemispheres, and temporal, superior, nasal and inferior quadrant. RESULTS: The mean RPC increased postoperatively, which was statistically significant in small vessels of peripapillary area (p-value = 0.045). The mean RNFL thickness decreased after surgery and it was statistically significant in the peripapillary (p-value = 0.032) and Inferior-Hemifield area (p-value = 0.036). The choriocapillaris changes were significant in Superior-Hemifield (p-value = 0.031) and Fovea (p-value = 0.03). CONCLUSION: Thyroid-associated orbitopathy patients have a tendency to decrease vascular density and correlated with disease activity more than stage of orbitopathy. There was not a strong and even discrepant result in linkage of RNFL thickness and other optic nerve function tests and TED patient status and it is needed to do studies with more epidemiologic power and same methodology of study to be more comparable.

Early macular and peripapillary vasculature dropout in active thyroid eye disease.

PURPOSE: To compare macular and peripapillary vasculatures in active thyroid eye disease (TED), not active not compressive (NANC) TED, and control eyes. METHODS: Twenty-one eyes of 12 active TED patients, 77 eyes of 43 NANC patients, and 65 eyes of 35 healthy normal subjects were recruited in this observational study. The participants underwent optical coherence tomography (OCT) and OCT angiography (OCT-A) of the peripapillary and macular areas. Macular ganglion cell complex (GCC) was measured in addition to peripapillary and macula superficial and deep vasculatures. RESULTS: Linear mixed models accounting for inter-eye correlation showed that whole macular and parafoveal superficial vessel densities were significantly lower in the active TED with values of 50.6 ± 4.3% and 52.7 ± 4.8%, respectively, compared with control group values of 53.7 ± 3.0% and 56.3 ± 3.2% (P = 0.03, P < 0.001, respectively). In contrast, only the nasal sector of parafoveal vasculature value was significantly lower in the NANC TED than in control eyes (P = 0.03) and in the active group than in the NANC group (P < 0.001). Similarly, the average peripapillary vessel density was lower in the active TED than in the NANC and control groups. No significant differences were observed in GCC thickness among active, NANC, and control groups. Whole superficial macular and parafoveal vessel densities were significantly correlated with visual field MD (r = 0.32, r = 0.30, respectively, both P < 0.001). CONCLUSIONS: OCT-A findings of lower peripapillary and macular vessel density values in the active TED eyes show subclinical retinal and optic nerve involvement.

Orbital basal cell adenoma: A case report.

Basal cell adenomas are uncommon benign epithelial tumors of the salivary gland. Orbital basal cell adenoma of the orbit has not been described before. The authors report an unusual case of basal cell adenoma that presented in the orbit. Immunohistochemical findings for the tumor are also described.