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The evaluation of retrobulbar fat tissue in Graves’ orbitopathy with shear-wave ultrasound elastography

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Abstract

Purpose

To evaluate retrobulbar adipose tissue of patients with active and inactive Graves’ orbitopathy (GO) by shear-wave ultrasound elastography (SWE).

Methods

Followed-up in our ophthalmology clinic due to GO, 72 eyes of 36 patients and 38 eyes of 19 healthy controls were included in this cross-sectional case–control study. Graves’ patients were divided into two subgroups under clinical activity score (CAS): active Graves’ orbitopathy (AGO) (CAS ≥ 3) and inactive Graves’ orbitopathy (IGO) (CAS < 3). SWE measurement values of retrobulbar adipose tissue of all participants were recorded in meters/second, and the intergroup comparisons were performed.

Results

Thirty-four eyes of 17 patients in AGO, 38 eyes of 19 patients in IGO, and 38 eyes of 19 participants in the control group were included in the study. Mean values measured from retrobulbar adipose tissue through SWE were 1.00 ± 0.01 m/sec in AGO, 1.16 ± 0.01 m/sec in IGO, and 0.94 ± 0.01 m/sec in the control groups. Even so, the mean SWE value was significantly higher in the IGO group than in the other groups (p < 0.001). Mean SWE values were significantly higher in the AGO group than in the controls (p = 0.008). In the correlation analysis performed, a significant positive correlation was found between SWE and Hertel exophthalmometer measurement values (p = 0.026, r = 0.212), and thyroid-stimulating hormone receptor antibody (TSHR-Ab) levels (p = 0.018, r = 0.224).

Conclusion

We detected SWE values of retrobulbar adipose tissue high in GO, especially in the IGO group. Such a situation, which we associated with the development of fibrosis, may be an indicator of unresponsiveness to immunomodulatory treatments.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of the study.

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Authors and Affiliations

  1. Department of Ophthalmology, Medicalpark Kocaeli Hospital, Kocaeli Health and Technology University, Başiskele, Kocaeli, Turkey

    Irfan Botan Gunes

  2. Department of Radiology, Medicalpark Kocaeli Hospital, Başiskele, Kocaeli, Turkey

    Hakan Yilmaz

  3. Department of Endocrinology, Medicalpark Kocaeli Hospital, Başiskele, Kocaeli, Turkey

    Eda Demir Onal

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  1. Irfan Botan Gunes
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Contributions

IBG and HY contributed to Validation Conceptualization, and Data Curation; IBG, EDO contributed to Methodology, Investigation; HY contributed to Software; IBG, HY, EDO Resources and Writing—Review and Editing; HY contributed to Visualization; IBG contributed to Supervision, Project Administration, Formal Analysis and Writing—Original Draft Preparation; and all authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Irfan Botan Gunes.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

For the present study, approval was obtained from the Local Ethics Committee for Clinical Practices of Kocaeli Health and Technology University with the number of 2023–39 under the 1961 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Gunes, I.B., Yilmaz, H. & Onal, E.D. The evaluation of retrobulbar fat tissue in Graves’ orbitopathy with shear-wave ultrasound elastography. Int Ophthalmol 44, 13 (2024). https://doi.org/10.1007/s10792-024-02962-9

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