Retinal and Choroidal Alterations in Thyroid-Associated Ophthalmopathy: A Systematic Review

Thyroid-associated ophthalmopathy (TAO), or Graves’ orbitopathy (GO), is a complex autoimmune disorder affecting orbital tissues, often leading to vision-threatening complications such as dysthyroid optic neuropathy (DON). In this systematic review, conducted following PRISMA guidelines, 22 studies...

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Main Authors: Alexandra Magdalena Ioana, Diana Andrei, Daniela Iacob, Sorin Lucian Bolintineanu
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/2/293
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author Alexandra Magdalena Ioana
Diana Andrei
Daniela Iacob
Sorin Lucian Bolintineanu
author_facet Alexandra Magdalena Ioana
Diana Andrei
Daniela Iacob
Sorin Lucian Bolintineanu
author_sort Alexandra Magdalena Ioana
collection DOAJ
description Thyroid-associated ophthalmopathy (TAO), or Graves’ orbitopathy (GO), is a complex autoimmune disorder affecting orbital tissues, often leading to vision-threatening complications such as dysthyroid optic neuropathy (DON). In this systematic review, conducted following PRISMA guidelines, 22 studies were evaluated to investigate the role of optical coherence tomography (OCT) in assessing retinal and choroidal changes in TAO. Parameters such as the retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), ganglion cell layer (GCL), and choroidal thickness were analyzed. RNFL changes varied by disease severity, with significant thinning in DON due to nerve fiber loss and thickening in early DON due to optic disk edema. Subfoveal choroidal thickness (SFCT) was consistently higher in active TAO, correlating positively with the clinical activity score (CAS) and proptosis, suggesting its role as a marker of disease activity. Subgroup analysis revealed that spectral-domain OCT (SD-OCT) was the most sensitive for detecting retinal changes. The findings highlight the effectiveness of OCT in detecting minor retinal and choroidal alterations in TAO. However, the variability of study designs, as well as the lack of longitudinal data, limits the ability to draw broad conclusions. Further standardized, long-term investigations are required to properly understand OCT’s diagnostic and prognostic value in TAO.
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spelling doaj-art-6c234600f9154cddbb696e737856b9072025-08-20T02:44:50ZengMDPI AGLife2075-17292025-02-0115229310.3390/life15020293Retinal and Choroidal Alterations in Thyroid-Associated Ophthalmopathy: A Systematic ReviewAlexandra Magdalena Ioana0Diana Andrei1Daniela Iacob2Sorin Lucian Bolintineanu3Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaDepartment of Balneology, Medical Rehabilitation and Rheumatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDepartment of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaDepartment of Anatomy and Embriology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaThyroid-associated ophthalmopathy (TAO), or Graves’ orbitopathy (GO), is a complex autoimmune disorder affecting orbital tissues, often leading to vision-threatening complications such as dysthyroid optic neuropathy (DON). In this systematic review, conducted following PRISMA guidelines, 22 studies were evaluated to investigate the role of optical coherence tomography (OCT) in assessing retinal and choroidal changes in TAO. Parameters such as the retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), ganglion cell layer (GCL), and choroidal thickness were analyzed. RNFL changes varied by disease severity, with significant thinning in DON due to nerve fiber loss and thickening in early DON due to optic disk edema. Subfoveal choroidal thickness (SFCT) was consistently higher in active TAO, correlating positively with the clinical activity score (CAS) and proptosis, suggesting its role as a marker of disease activity. Subgroup analysis revealed that spectral-domain OCT (SD-OCT) was the most sensitive for detecting retinal changes. The findings highlight the effectiveness of OCT in detecting minor retinal and choroidal alterations in TAO. However, the variability of study designs, as well as the lack of longitudinal data, limits the ability to draw broad conclusions. Further standardized, long-term investigations are required to properly understand OCT’s diagnostic and prognostic value in TAO.https://www.mdpi.com/2075-1729/15/2/293thyroid-associated ophthalmopathythyroid eye diseaseGraves’ ophthalmopathyGraves’ diseaseoptical coherence tomographyretina
spellingShingle Alexandra Magdalena Ioana
Diana Andrei
Daniela Iacob
Sorin Lucian Bolintineanu
Retinal and Choroidal Alterations in Thyroid-Associated Ophthalmopathy: A Systematic Review
Life
thyroid-associated ophthalmopathy
thyroid eye disease
Graves’ ophthalmopathy
Graves’ disease
optical coherence tomography
retina
title Retinal and Choroidal Alterations in Thyroid-Associated Ophthalmopathy: A Systematic Review
title_full Retinal and Choroidal Alterations in Thyroid-Associated Ophthalmopathy: A Systematic Review
title_fullStr Retinal and Choroidal Alterations in Thyroid-Associated Ophthalmopathy: A Systematic Review
title_full_unstemmed Retinal and Choroidal Alterations in Thyroid-Associated Ophthalmopathy: A Systematic Review
title_short Retinal and Choroidal Alterations in Thyroid-Associated Ophthalmopathy: A Systematic Review
title_sort retinal and choroidal alterations in thyroid associated ophthalmopathy a systematic review
topic thyroid-associated ophthalmopathy
thyroid eye disease
Graves’ ophthalmopathy
Graves’ disease
optical coherence tomography
retina
url https://www.mdpi.com/2075-1729/15/2/293
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