Graves Ophthalmopathy a neglected comorbidity of Graves’ Disease; A Detailed investigation and management of Sixty Eight Patients in a tertiary healthcare center.

Aim: To compare the measurements of macular thickness, intraocular pressure and retinal fiber nerve layer (RFNL) and hormone parameters before and after antithyroid therapy in patients with Graves’ Ophthalmopathy (GO). Methods: A prospective observational study conducted at a tertiary care center. Patients with GO were included and scored (Clinical Activity Score, CAS) according to EUGOGO guideline. The participants underwent optical coherence tomography (OCT) and OCT angiography (OCT-A) of the peripapillary and macular areas. Baseline and follow-up hormone parameters including free T3, free T4, Thyroid stimulating hormone (TSH), Thyroid receptor autoantibodies and intravitreal measurements (RFNL, macular thickness, intraocular pressure) were performed and compared in the current study. Results: During the 24 weeks, CAS was significantly decreased (0.5±0.8 vs 0.1±0.4, p=0.00). Although measurements of Intraocular pressure (14.9±2.8 vs 14.2±1.9), RFNL (100.2±9.05 vs 99.9±8.7) and macular thickness (274.7±42.9 vs 271.2±43.3) were between baseline and were similar after antithyroid therapy, baseline RFNL measurements were significantly correlated with serum TRAbs (p=0.008), fT3 (p=0.01), fT4 (p=0.003), negatively. Baseline intraocular pressure and macular thickness were also negatively correlated with serum TSH levels. Conclusion: Serum fT3, fT4 and TRAbs levels were the main significant factor for the evaluation of intraocular structure, especially retinal nerve in patients with GO.