Abstract ID: 26-124
Do chorioretinal folds signal severity in thyroid eye disease? Clinical outcomes and orbital apex volume assessment
Author: Marie Callet Base Hospital / Institution: Rothschild Foundation Hospital
Presentation Type: Oral Presentation Session: Orbit IIDate: 12th SeptemberTime: 15.25PM
Purpose
To determine whether chorioretinal folds (CRF) are associated with severe thyroid eye disease (TED) and apical crowding using paired intra-individual analysis.
Methods
In this retrospective 1:1 matched study based on a registry of 324 consecutive TED patients, 26 eyes from 19 patients with CRF were identified. Twelve unilateral cases allowed paired comparison with contralateral TED eyes without CRF. Clinical severity markers included dysthyroid optic neuropathy (DON), severe exposure keratopathy, and severe ocular hypertension. Orbital apex volume (OAV) was measured using standardized semi-automated CT segmentation. Paired continuous variables were analyzed using Wilcoxon matched-pairs signed-rank tests and binary outcomes using McNemar exact tests with false discovery rate correction.
Results
CRF eyes frequently exhibited severe TED features, including DON (73%) and optic disc edema (65%). In paired analyses, intraocular pressure was significantly higher in CRF eyes compared with contralateral controls (median paired difference 3.75 mmHg, p=0.0005). OAV was significantly reduced in CRF eyes (median paired difference 0.295 cm³, p=0.0005), consistent with increased apical crowding. Although DON and severe keratopathy were observed predominantly in CRF eyes among discordant pairs, paired binary comparisons did not reach statistical significance. Central macular thickness differed significantly between groups, whereas subfoveal choroidal and choriocapillaris thickness showed no significant differences
Conclusion
CRF in TED are associated with elevated intraocular pressure and reduced orbital apex volume, supporting a mechanical, pressure-related mechanism linked to apical crowding. CRF may represent a structural marker of posterior orbital stress within the spectrum of severe TED.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Raphael | Lejoyeux | Hospital Foundation Rothschild |
| Olivier | Galatoire | Hospital Foundation Rothschild |
| Aude | Couturier | Hospital Foundation Rothschild |