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갑상샘눈병증에서 갑상샘자극호르몬수용체 자가항체가 망막 및 맥락막혈관에 미치는 영향

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Author(s)
Ji Woong ParkYu Cheol KimDong Cheol Lee
Keimyung Author(s)
Kim, Yu CheolLee, Dong Cheol
Department
Dept. of Ophthalmology (안과학)
Journal Title
대한안과학회지
Issued Date
2020
Volume
61
Issue
10
Keyword
Choroidal thicknessInflammationOptical coherence tomographyThyroid eye diseaseThyroid stimulating antibodies
Abstract
Purpose:
We describe the use of optical coherence tomography angiography (OCTA) to investigate the relationship between thyroid-stimulating hormone receptor autoantibody (TSHR Ab) levels and retinal vessel and choroid changes in patients with thyroid eye disease (TED).

Methods:
We enrolled 23 TED patients with abnormal TSHR Ab levels (>1.5 IU/L; all right eyes). Sex, visual acuity, intraocular pressure and TSHR Ab level were recorded at baseline and after 1 month. We used OCTA to determine the size of the superficial and deep foveal avascular zones (sFAZ and dFAZ, respectively), as well as the 1-mm foveal and 3-mm parafoveal superficial capillary plexus density (sCPD) and choroidal thickness (CT), at baseline and after 1 month later.

Results:
The mean age of the 23 patients was 43.30 ± 16.16 years and 18 were female (78%). The mean baseline TSHR Ab level was 11.47 ± 11.22 IU/L. The TSHR Ab level showed non-significant correlations with sFAZ and dFAZ size, and with the 1-mm foveal sCPD; the correlation coefficients were 0.173, 0.073, and 0.266, respectively (p = 0.465, p = 0.759, and p = 0.224, respectively). The 3-mm parafoveal sCPD and CT showed non-significant correlations with the TSHR Ab level; the correlation coefficients were -0.185 and -0.16 (p = 0.421, p = 0.487).

Conclusions:
In TED patients, changes in TSHR Ab level over 1 month do not affect retinal blood flow or CT, but show a non-significant positive association with the 1-mm foveal sCPD.
목적:
갑상샘눈병증(thyroid eye disease, TED) 환자에서 빛간섭단층촬영혈관조영술(optical coherence tomography angiography, OCTA)을 이용하여 갑상샘자극호르몬수용체 자가항체(thyroid stimulating hormone receptor antibody, TSHR Ab)의 변화와 망막혈관 및 맥락막의 변화의 연관성을 알아보고자 하였다.

대상과 방법:
TED로 진단받은 환자 중 TSHR Ab 이상(>1.5 IU/L)을 보인 환자군 23명(우안)을 대상으로 망막의 표층부 무혈관 부위 (superficial foveal avascular zone, sFAZ) 및 심층부 무혈관 부위(deep foveal avascular zone, dFAZ) 크기, 황반부중심의 지름 1 mm 중심와, 3 mm 중심와부근 영역의 표층모세혈관총밀도(superficial capillary plexus density, sCPD) 및 맥락막두께(choroidal thickness, CT)를 측정하였고 내원 1개월 이후 반복 시행하여 TSHR Ab 변화에 대한 상관관계를 분석하였다.

결과:
sFAZ, dFAZ, 1 mm 중심와 sCPD에서 양의 경향성을 보였으나(p=0.465, p=0.759, p=0.224), 3 mm 중심와부근 sCPD와 CT에서는 음의 경향성을 보이며, 모든 변수에 통계적인 유의성은 없었다(p=0.421, p=0.487).

결론:
TED 환자에서 1개월 간의 TSHR Ab의 변화량에 따라 망막혈류와 맥락막두께 변화량에는 영향이 없으나, 1 mm 중심와 sCPD에서는 강한 양의 경향성을 가진다.
Alternative Title
Effects of Thyroid-stimulating Hormone Receptor Autoantibody on Retinal and Choroidal Vessels in Thyroid Eye Disease
Keimyung Author(s)(Kor)
김유철
이동철
Publisher
School of Medicine (의과대학)
Citation
Ji Woong Park et al. (2020). 갑상샘눈병증에서 갑상샘자극호르몬수용체 자가항체가 망막 및 맥락막혈관에 미치는 영향. 대한안과학회지, 61(10), 1121–1128. doi: 10.3341/jkos.2020.61.10.1121
Type
Article
ISSN
2092-9374
Source
https://www.jkos.org/journal/view.php?number=11579
DOI
10.3341/jkos.2020.61.10.1121
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42902
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Ophthalmology (안과학)
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