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Front. Endocrinol. | doi: 10.3389/fendo.2019.00707

A comparison of Doppler flow parameters in the ophthalmic artery and central retinal artery in patients with Graves’ disease and toxic nodular goiter

 Dorota Walasik-Szemplińska1*,  Grzegorz W. Kaminski2, Małgorzata Mańczak3, Joanna Widłak4 and Iwona Sudoł-Szopińska5, 6
  • 1Sensor Cliniq, Poland
  • 2Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine (Poland), Poland
  • 3Other, Poland
  • 4Ludwik Rydygier’ Provincial Polyclinical Hospital in Torun, Poland
  • 5National Institute of Geriatrics, Rheumatology and Rehabilitation, Poland
  • 6Medical University of Warsaw, Poland

Purpose: Despite unquestionable clinical usefulness of Clinical Activity Score, the evaluating system needs frequent supplementation. One of such diagnostic tools is Doppler imaging that is used for the analysis of flow in the retrobulbar vessels. The improvement of the reliability and sensibility of measurements could make Doppler imaging an everyday clinical tool and improve the efficacy of treatment in patients with active thyroid-associated orbitopathy. However, the systemic influence of hyperthyroidism on the orbital vessels can falsify the assessment of local inflammation severity.
Methods: To eliminate the influence of systemic hyperthyroidism on orbital vessels, we compared peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI) in the central retinal artery (CRA) and ophthalmic artery (OA) in patients with hyperthyroidism in the course of Graves’ disease without any detectable orbital changes, (CAS=0) and toxic nodular goiter.
Results: There were no statistically significant differences between the patients with Graves’ disease and toxic nodular goiter in terms of the examined parameters in either of the arteries. However, higher PSV and RI and lower EDV in the CRA as well as higher PSV and EDV and unchanged RI in the OA were found in the patients with Graves’ diseases and toxic nodular goiter.
Conclusion: Hyperthyroidism and hyperthyroidism-induced hyperkinetic flow have a systemic influence on the orbital vessels, irrespective of the cause of hyperthyreosis. Thus, it is necessary to compare the flow parameters in retrobulbar vessels in Graves’ patients with the toxic nodular goiter patients to eliminate the systemic influence of hyperthyroidism on the orbital vessels.

Keywords: Graves’ disease, Graves’ ophthalmopathy, nodular goiter, Hyperthyroidism, Color Doppler ultrasonography, CRA, OA

Received: 10 Jul 2019; Accepted: 02 Oct 2019.

Copyright: © 2019 Walasik-Szemplińska, Kaminski, Mańczak, Widłak and Sudoł-Szopińska. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Dorota Walasik-Szemplińska, Sensor Cliniq, Warsaw, 01-013, Masovian, Poland, dszemplinska1@gmail.com