Comparison of choroidal thickness in patients with active and stable thyroid eye disease / Comparação da espessura da coroide em pacientes com doença ocular tireoidiana ativa e estável

ABSTRACT Purpose: To compare the choroidal thickness in active and stable phases of thyroid eye disease. Methods: Forty-seven eyes of 47 patients with thyroid eye disease were prospectively studied. Patients were evaluated on the basis of their clinical activity scores, with scores 33 defined as active disease. Subfoveal, temporal macular, nasal macular, temporal peripapillary, and nasal peripapillary choroidal thickness measurements were performed with Cirrus enhanced depth imaging spectral-domain optical coherence tomography, and the results in the two groups were compared. Results: Twenty-four patients were int he active group, whereas 23 patients were in the stable group. Choroidal thickness was significantly higher in the subfoveal and temporal macular regions in the active group. Although the nasal macular and peripapillary values were also higher in the active group, the difference was insignificant. Conclusions: Subfoveal choroidal thickness was significantly higher in patients with thyroid eye disease in the active phase than in those with stable phase disease.

RESUMO Objetivo: Comparar a espessura da coroide nas fases ativa e estável da doença ocular tireoidiana. Métodos: Quarenta e sete olhos, de 47 pacientes com doença ocular tireoidiana foram estudados prospectivamente. Os pacientes foram avaliados com base em seus escores de atividade clínica, com escore de 33 definidos como doença ativa. As medidas subfoveais, maculares temporais, maculares nasais, peripapilares temporais e da espessura da coroide peripapilar foram realizadas com tomografia de coerência óptica de domínio espectral Cirrus EDI, e os resultados nos dois grupos foram comparados. Resultados: Vinte e quarto pacientes estavam no grupo ativo, enquanto 23 pacientes estavam no grupo estável. A espessura da coroide foi significativamente maior nas regiões macular subfoveal e temporal no grupo ativo. Embora os valores maculares e peripapilares nasais também fossem maiores no grupo ativo, a diferença foi insignificante. Conclusões: A espessura da coroide subfoveal foi significativamente maior em pacientes com doença ocular tireoidiana na fase ativa do que naqueles com doença na fase estável.

Comparison of choroidal thickness in patients with active and stable thyroid eye disease.

PURPOSE: To compare the choroidal thickness in active and stable phases of thyroid eye disease. METHODS: Forty-seven eyes of 47 patients with thyroid eye disease were prospectively studied. Patients were evaluated on the basis of their clinical activity scores, with scores 33 defined as active disease. Subfoveal, temporal macular, nasal macular, temporal peripapillary, and nasal peripapillary choroidal thickness measurements were performed with Cirrus enhanced depth imaging spectral-domain optical coherence tomography, and the results in the two groups were compared. RESULTS: Twenty-four patients were int he active group, whereas 23 patients were in the stable group. Choroidal thickness was significantly higher in the subfoveal and temporal macular regions in the active group. Although the nasal macular and peripapillary values were also higher in the active group, the difference was insignificant. CONCLUSIONS: Subfoveal choroidal thickness was significantly higher in patients with thyroid eye disease in the active phase than in those with stable phase disease.

Anterior Chamber Stabilization in Combined Penetrating Keratoplasty With Scleral-Sutured Posterior Chamber Intraocular Lens Implantation.

PURPOSE: To describe a novel technique for a stabilized penetrating keratoplasty procedure with implantation of a scleral-sutured posterior chamber intraocular lens in which the anterior chamber (AC) is maintained and the globe stabilized without using a Flieringa ring. METHODS: In this procedure, a deep anterior corneal lamella separation was created. Four small incisions were made in each quadrant along the outer edge of the trephination groove of the residual stromal bed (RSB). The first incision at the 9-o'clock position was advanced with scissors in both clockwise and counterclockwise directions. This procedure was repeated in the remaining 3 quadrants, creating 4 small bridges between the RSB and corneal rim. A donor corneal button coated with a viscoelastic material was sutured at 3 incision sites leaving 1 quadrant sutureless to allow sufficient incision width for IOL insertion for scleral fixation. Scleral fixation of a 1-piece polymethyl methacrylate (PMMA) IOL was performed. After sequential cutting of the bridges, the RSB was removed from the AC. Ten eyes of 10 patients underwent this procedure without significant complications. RESULTS: There were no complications related to the open-sky procedure. Globe stabilization was achieved in all surgeries. Endothelial cell loss, visual acuities, and graft failure rates were comparable with the reports of AC-protecting penetrating keratoplasty surgeries. CONCLUSIONS: This technique provides a secured AC and stabilized globe without the use of a Flieringa ring and increases the surgical safety without a significant reduction of the graft endothelial cell density.