الفهرس 
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Abstract
Summary
Thyroid-associated ophthalmopathy (TAO) is a systemic autoimmune disorder or an organ-specific autoimmune inflammatory disease of orbital tissues. It is characterized by inflammatory cellular infiltration with lymphocytes, plasma cells, macrophages and mast cells. The most obvious pathological changes in orbital tissues include interstitial tissue edema, orbital fat hyperplasia and massively swollen extraocular muscles, which may cause orbital compression symptoms.
Approximately 20% of patients with immune thyroid diseases will develop TAO, and 25–50% of TAO cases are closely related to hyperthyroidism, commonly termed as Graves’ ophthalmopathy, with higher morbidity in females. The exact pathogenesis of TAO remains unknown, but the clinical manifestations can be explained by the expansion of orbital volume due to autoimmune inflammatory infiltration.
It is sometimes difficult to diagnose optic nerve involvement in TAO because of the variations in clinical appearances. Visual acuity, visual field, color vision and optic disk configuration are all subject to change, and the findings are not necessarily congruent. Research has dealt with the thickness of the macular ring and the retinal nerve fiber layer (RNFL) in TAO patients, with conflicting results.
Different techniques have been employed to analyze the retinal and choroidal changes in TAO patients. Optical coherence tomography (OCT) is a relatively new non-invasive, trans-pupillary imaging technology that provides high-resolution cross-sectional images of the retina, including the RNFL. The technology gives qualitative and quantitative data on the macular ring and the RNFL and has already proven useful for assessing retinal diseases and optic disk pathologies.
OCT has been used extensively to diagnose and monitor RNFL loss in patients with glaucoma, and to evaluate macular holes, macular edema, age-related macular degeneration, and other disorders Sayin et al. found TAO patients had thinner inferior retinal nerve fiber layer (RNFL) thickness and macular thickness.
The study is aimed to evaluate the retinal nerve fiber layer thickness in patients with thyroid ophthamopathy with OCT.
This is analytic observational case-control study, was carried out on patients divided into 2 groups: (the study group); consisted of patients with TAO (30 eyes) at different stages of the disease, (the control group): included (30 eyes) comprised healthy subjects with no ocular pathologies who had been evaluated at the ophthalmology department, at the period between 1st November 2019 to 29th February 2020.
The main results of the study revealed that:
● There was no statistically significant difference between the studied groups as regard demographic data.
● There was high statistically significant difference between the studied groups as regard hertel exophthalmometer as it was higher in cases group.
● There was no statistically significant difference between the studied groups as regard retinal nerve fiber layer.
● There was high statistically significant difference between the studied groups as regard mean macula thickness as it was higher in control group.
● There was statistically significant difference between the studied groups as regard central, nasal, inferior and temporal macula thickness as they were higher in control group.
● There was statistically significant difference between the studied groups as regard disc area and C/D ratio as it was higher in cases group.
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.