Impact of Balanced Orbital Decompression Surgery on Vascularization in Thyroid Orbitopathy: An Explanatory Study with OCT, OCT-Angiography and Doppler Ultrasonography
Author: Burcin Gogus Camli
Base Hospital / Institution: Marmara University
Rapid fire oral presentation
Abstract ID: 24-458
Purpose
To investigate the effects of balanced orbital decompression (BOD) surgery on conjunctival, orbital, retinal and choroidal vascularization and the relationships among these structures.
Methods
BOD was performed on 30 orbits of 15 inactive thyroid orbitopathy (TO) patients. Intraocular pressure (IOP), proptosis measurement, conjunctival hyperemia using the Efron classification, peak systolic volume (PSV), end-diastolic volume (EDV) and resistance index (RI) of the ophthalmic artery (OA) and central retinal artery (CRA) using color Doppler ultrasonography, subfoveal choroidal thickness (SCT) and choroidal vascular index (CVI) using swept-source optical coherence tomography, macular superficial (SCP), deep capillary plexus (DCP), choriocapillaris (CC) vessel densities using swept-source OCT-angiography, and superior ophthalmic vein (SOV) diameter using MRI were measured preoperatively and at 1st, 3rd and 6th months postoperatively.
Results
BOD resulted in a regression of proptosis by 3.93±0.27 mm (p<0.001). IOP was significantly decreased at the 3rd postoperative month (mean reduction= 1.90±3.47 mmHg, p=0.002). A significant reduction in conjunctival hyperemia was found in all postoperative follow-ups (p<0.001). OA-PSV and OA-EDV at the 3rd month, and CRA-RI at the 6th month were significantly increased among follow-ups (p<0.001; p=0.002; p=0.009, respectively). SCP, DCP, and CC vessel densities in the central quadrant significantly increased between the 1st and 6th months (p=0.003; p=0.014; p=0.003, respectively), superior SCP and DCP vessel densities were significantly reduced at all visits (p=0.021 and p=0.022, respectively). The foveal avascular zone showed a significant decrease at the follow-ups (p=0.001). CVI was decreased at the follow-ups (p=0.011), which is compatible with the significant reduction of SOV diameter (p<0.001).
Conclusion
This study showed that increased OA velocity post-BOD led to change in resistance of the SRA through retinal vasoconstriction. BOD surgery may alleviate choroidal and conjunctival congestion by decreasing SOV diameter.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Volkan | Dericioglu | Marmara University |
| Didem | Dizdar Yigit | Marmara University |
| Mustafa | Hurmuzlı | Marmara University |
| Onur | Bugdayci | Marmara University |
| Mehmet Orkun | Sevik | Marmara University |
| Ozlem | Sahin | Marmara University |
