Radiotherapy-induced changes in corneal morphology and biomechanics in myopathic thyroid eye disease

PurposeTo assess differences in corneal morphology and biomechanics between patients with myopathic thyroid eye disease (TED) and normal controls (NCs), as well as to evaluate these changes following radiotherapy.MethodsPatients with active myopathic TED and age-, sex-, and spherical equivalent-matc...

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Main Authors: Pengsen Wu, Jing Rao, Shenglan Yang, Xiaohan He, Yuqing Wu, Guiqin Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1612518/full
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author Pengsen Wu
Jing Rao
Shenglan Yang
Xiaohan He
Yuqing Wu
Guiqin Liu
author_facet Pengsen Wu
Jing Rao
Shenglan Yang
Xiaohan He
Yuqing Wu
Guiqin Liu
author_sort Pengsen Wu
collection DOAJ
description PurposeTo assess differences in corneal morphology and biomechanics between patients with myopathic thyroid eye disease (TED) and normal controls (NCs), as well as to evaluate these changes following radiotherapy.MethodsPatients with active myopathic TED and age-, sex-, and spherical equivalent-matched NCs were enrolled in this study. All patients underwent radiotherapy and were followed up for 6 months post-treatment. Complete ophthalmic examinations were conducted for all subjects. Corneal morphology was evaluated using Pentacam, and biomechanics were assessed with Corvis ST tonometry, both before and 6 months post-radiotherapy.ResultsThis prospective, comparative clinical study involved 50 eyes from 50 TED patients and 30 eyes from 30 NCs. Post-radiotherapy, the intraocular pressure (IOP), proptosis, disease activity, diplopia, eye motility restriction and muscular index in TED patients significantly improved. Corneal morphological parameters such as elevation deviation, including back elevation (Db), pachymetric progression, relational thickness, overall deviation, and the index of surface variance, were significantly greater in TED patients compared to NCs, while Ambrosio’s Relational Thickness maximum was significantly lower. After radiotherapy, Db decreased, and posterior surface astigmatism increased with statistical significance. Significant biomechanical changes were observed in patients with TED after adjustment with biomechanically corrected IOP, including reduced A2 time and peak distance, increased tomographic and biomechanical index (TBI), as well as diminished maximum whole eye movement length (WEML). Post-radiotherapy, a significant increase in WEML was observed. Correlation analysis suggested that improvements in ocular biomechanics may be linked to reductions in IOP and proptosis.ConclusionPatients with myopathic TED demonstrated observable corneal alterations, including increased steepness, surface irregularity, reduced corneal hysteresis, and decreased orbital compliance. These biomechanical changes were associated with elevated TBI values, indicating heightened susceptibility to corneal ectatic disorders. Ocular biomechanical parameters may serve as as potential quantitative biomarkers for assessing treatment effectiveness in TED management.
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spelling doaj-art-a796fc6c7c0f4f96a839bf801e569de22025-08-20T02:32:20ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.16125181612518Radiotherapy-induced changes in corneal morphology and biomechanics in myopathic thyroid eye diseasePengsen Wu0Jing Rao1Shenglan Yang2Xiaohan He3Yuqing Wu4Guiqin Liu5Shenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, ChinaShenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, ChinaShenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, ChinaShenzhen OCT Hospital, Shenzhen, ChinaShenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, ChinaShenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, ChinaPurposeTo assess differences in corneal morphology and biomechanics between patients with myopathic thyroid eye disease (TED) and normal controls (NCs), as well as to evaluate these changes following radiotherapy.MethodsPatients with active myopathic TED and age-, sex-, and spherical equivalent-matched NCs were enrolled in this study. All patients underwent radiotherapy and were followed up for 6 months post-treatment. Complete ophthalmic examinations were conducted for all subjects. Corneal morphology was evaluated using Pentacam, and biomechanics were assessed with Corvis ST tonometry, both before and 6 months post-radiotherapy.ResultsThis prospective, comparative clinical study involved 50 eyes from 50 TED patients and 30 eyes from 30 NCs. Post-radiotherapy, the intraocular pressure (IOP), proptosis, disease activity, diplopia, eye motility restriction and muscular index in TED patients significantly improved. Corneal morphological parameters such as elevation deviation, including back elevation (Db), pachymetric progression, relational thickness, overall deviation, and the index of surface variance, were significantly greater in TED patients compared to NCs, while Ambrosio’s Relational Thickness maximum was significantly lower. After radiotherapy, Db decreased, and posterior surface astigmatism increased with statistical significance. Significant biomechanical changes were observed in patients with TED after adjustment with biomechanically corrected IOP, including reduced A2 time and peak distance, increased tomographic and biomechanical index (TBI), as well as diminished maximum whole eye movement length (WEML). Post-radiotherapy, a significant increase in WEML was observed. Correlation analysis suggested that improvements in ocular biomechanics may be linked to reductions in IOP and proptosis.ConclusionPatients with myopathic TED demonstrated observable corneal alterations, including increased steepness, surface irregularity, reduced corneal hysteresis, and decreased orbital compliance. These biomechanical changes were associated with elevated TBI values, indicating heightened susceptibility to corneal ectatic disorders. Ocular biomechanical parameters may serve as as potential quantitative biomarkers for assessing treatment effectiveness in TED management.https://www.frontiersin.org/articles/10.3389/fmed.2025.1612518/fullthyroid eye diseaseradiotherapycorneal morphologybiomechanicsCorvis ST
spellingShingle Pengsen Wu
Jing Rao
Shenglan Yang
Xiaohan He
Yuqing Wu
Guiqin Liu
Radiotherapy-induced changes in corneal morphology and biomechanics in myopathic thyroid eye disease
Frontiers in Medicine
thyroid eye disease
radiotherapy
corneal morphology
biomechanics
Corvis ST
title Radiotherapy-induced changes in corneal morphology and biomechanics in myopathic thyroid eye disease
title_full Radiotherapy-induced changes in corneal morphology and biomechanics in myopathic thyroid eye disease
title_fullStr Radiotherapy-induced changes in corneal morphology and biomechanics in myopathic thyroid eye disease
title_full_unstemmed Radiotherapy-induced changes in corneal morphology and biomechanics in myopathic thyroid eye disease
title_short Radiotherapy-induced changes in corneal morphology and biomechanics in myopathic thyroid eye disease
title_sort radiotherapy induced changes in corneal morphology and biomechanics in myopathic thyroid eye disease
topic thyroid eye disease
radiotherapy
corneal morphology
biomechanics
Corvis ST
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1612518/full
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AT shenglanyang radiotherapyinducedchangesincornealmorphologyandbiomechanicsinmyopathicthyroideyedisease
AT xiaohanhe radiotherapyinducedchangesincornealmorphologyandbiomechanicsinmyopathicthyroideyedisease
AT yuqingwu radiotherapyinducedchangesincornealmorphologyandbiomechanicsinmyopathicthyroideyedisease
AT guiqinliu radiotherapyinducedchangesincornealmorphologyandbiomechanicsinmyopathicthyroideyedisease