Orbitopati gelişmeyen graves tanılı hastalarda kontrast duyarlılık fonksiyonu ve optik sinir başının değerlendirilmesi
Küçük Resim Yok
Tarih
2025
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Graves hastalarında fonksiyonel göz hasarı gelişmeden önce, subklinik evrede gerçekleştirilecek erken tanı ve uygun takip yöntemleriyle geri dönüşü olmayan görme kaybının önlenmesi amaçlanmıştır. Materyal ve Metod: 30 Graves orbitopatisi olan hasta, 30 orbitopati gelişmeyen Graves tanılı hasta ve 30 gönüllü çalışmaya dahil edildi. Her üç grubun tam oftalmolojik muayeneleri yapıldı. Hertel ekzoftalmometre ile proptozis değerlendirildi. Klinik aktivasyon, klinik aktivasyon skoru ile değerlendirildi. Hastalık şiddeti Europen Group on Graves Orbitopathy sınıflaması ile değerlendirildi. FACT paneli kullanarak hastaların uzaysal kontrast duyarlılık fonksiyonu ölçüldü. Her üç gruptaki hastalardan Spektral Domain Optik Koherens Tomografi (SD-OKT) ile ölçümler alındı. SD-OKT ile peripapiller retinal sinir lifi tabakası (RSLT) kalınlığı, EDTRS'nın 9 alanında makula kalınlığı değerlendirildi. Tüm hastaların OKT görüntüleri ImageJ programına yüklenerek koroidal vasküler indeks (KVİ) değeri hesaplandı. Bulgular: Gruplar arasında peripapiller RSLT kalınlığı, koroid kalınlığı, KVİ karşılaştırıldılğında anlamlı fark izlenmedi (p>0.05). Orbitopatili grupta 3 cpd, 6cpd, 12 cpd ve 18 cpd uzaysal frekanslarda azalma kaydedildi (P<0.05). Klinik orbitopatisi olmayan grubunda ise 12 cpd ve 18 cpd uzaysal frekanslarda azalma kaydedildi. Bu azalma istatiksel açıdan anamlıydı (P<0.05). 6 cpd uzaysal frekanstan itibaren, klinik olarak orbitopati bulunan grup ile orbitopatisi olmayan grubun kontrast duyarlılık değerleri birbirine yaklaşmıştır. Bununla birlikte, orbitopatili grupta kontrast duyarlılık değerlerindeki azalma daha belirgin bulunmuştur (P=0.011). 12 cpd ve 18 cpd uzaysal frekanslarda, orbitopatili grup ile orbitopatisi olmayan grubun kontrast duyarlılık değerleri benzer olmakla birlikte, her iki grup da sağlıklı popülasyona kıyasla anlamlı derecede daha düşük değerler göstermiştir (sırasıyla P=0.005, P=0.001). Sonuç: Orbitopati gelişen ve gelişmeyen Graves hastalarında kontrast duyarlılık azalmaktadır. Özellikle orbitopati gelişmeyen hastalarda kontrast duyarlılık testi, erken tanı ve takipler açısından rutinde kullanılan görme keskinlik ölçümlerine ek bilgiler sağlayabilir. v Anahtar kelime: Graves hastalığı, kontrast duyarlılık, koroidal vasküler indeks, retina, tiroid orbitopati
Purpose: The aim is to prevent irreversible vision loss in Graves' patients by enabling early diagnosis and appropriate follow-up methods during the subclinical stage before functional eye damage occurs. Material and Method: The study included 30 patients diagnosed with Graves' orbitopathy, 30 patients diagnosed with Graves' disease who did not develop orbitopathy, and 30 healthy volunteers. Comprehensive ophthalmological examinations were conducted for all three groups. Clinical activity was assessed using the clinical activity score, while disease severity was evaluated according to the European Group on Graves Orbitopathy classification. The spatial contrast sensitivity function of the participants was measured using the Functional Acuity Contrast Test (FACT) panel. Additionally, measurements were obtained from all participants using Spectral Domain Optical Coherence Tomography (SD-OCT), focusing on peripapillary retinal nerve fiber layer (RNFL) thickness and macular thickness across nine areas of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. OCT images were analyzed using the ImageJ software to calculate the choroidal vascular index (CVI). Results: No significant difference was observed when RNFL thickness, choroidal thickness, and CVI were compared between the groups (p>0.05). In the orbitopathy group, a decrease was noted in the spatial frequencies of 3 cpd, 6cpd, 12 cpd and 18 cpd (P<0.05). In the group without clinical orbitopathy, a decrease was noted in 12 cpd and 18 cpd spatial frequencies. This decrease was statistically significant (P<0.05). Starting from 6 cpd spatial frequency, contrast sensitivity values of the group with clinical orbitopathy and the group without orbitopathy became closer. However, the decrease in contrast sensitivity values was found to be more pronounced in the group with orbitopathy (P=0.011). At 12 cpd and 18 cpd spatial frequencies, contrast sensitivity values of the group with orbitopathy and the group without orbitopathy were similar, but both groups showed significantly lower values compared to the healthy population (P=0.005, P=0.001, respectively). vii Conclusion: Contrast sensitivity is diminished in patients with Graves' disease, both with and without orbitopathy. Notably, in patients without orbitopathy, contrast sensitivity testing may offer valuable supplementary information beyond standard visual acuity assessments, aiding in early diagnosis and monitoring. Keywords: Graves' disease, contrast sensitivity, choroidal vascular index, retina, thyroid orbitopathy
Purpose: The aim is to prevent irreversible vision loss in Graves' patients by enabling early diagnosis and appropriate follow-up methods during the subclinical stage before functional eye damage occurs. Material and Method: The study included 30 patients diagnosed with Graves' orbitopathy, 30 patients diagnosed with Graves' disease who did not develop orbitopathy, and 30 healthy volunteers. Comprehensive ophthalmological examinations were conducted for all three groups. Clinical activity was assessed using the clinical activity score, while disease severity was evaluated according to the European Group on Graves Orbitopathy classification. The spatial contrast sensitivity function of the participants was measured using the Functional Acuity Contrast Test (FACT) panel. Additionally, measurements were obtained from all participants using Spectral Domain Optical Coherence Tomography (SD-OCT), focusing on peripapillary retinal nerve fiber layer (RNFL) thickness and macular thickness across nine areas of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. OCT images were analyzed using the ImageJ software to calculate the choroidal vascular index (CVI). Results: No significant difference was observed when RNFL thickness, choroidal thickness, and CVI were compared between the groups (p>0.05). In the orbitopathy group, a decrease was noted in the spatial frequencies of 3 cpd, 6cpd, 12 cpd and 18 cpd (P<0.05). In the group without clinical orbitopathy, a decrease was noted in 12 cpd and 18 cpd spatial frequencies. This decrease was statistically significant (P<0.05). Starting from 6 cpd spatial frequency, contrast sensitivity values of the group with clinical orbitopathy and the group without orbitopathy became closer. However, the decrease in contrast sensitivity values was found to be more pronounced in the group with orbitopathy (P=0.011). At 12 cpd and 18 cpd spatial frequencies, contrast sensitivity values of the group with orbitopathy and the group without orbitopathy were similar, but both groups showed significantly lower values compared to the healthy population (P=0.005, P=0.001, respectively). vii Conclusion: Contrast sensitivity is diminished in patients with Graves' disease, both with and without orbitopathy. Notably, in patients without orbitopathy, contrast sensitivity testing may offer valuable supplementary information beyond standard visual acuity assessments, aiding in early diagnosis and monitoring. Keywords: Graves' disease, contrast sensitivity, choroidal vascular index, retina, thyroid orbitopathy
Açıklama
Anahtar Kelimeler
Göz Hastalıkları, Eye Diseases
