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Artificial Intelligence-based quantitative evaluation of retinal vascular parameters in thyroid-associated ophthalmopathy

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Abstract

Purpose

Thyroid-associated ophthalmopathy (TAO) may result in increased metabolism and abnormalities in microcirculation. The fractal dimension (Df) of retinal vessels has been shown to be related to the pathology of a number of ophthalmic disorders, but it hasn’t been investigated in TAO.

Methods

We analyzed 1078 participants aged 18 to 72 (548 healthy volunteers and 530 TAO). Images were captured using a non-mydriatic 45-degree fundus camera. Baseline retinal characteristics, such as vessel width, tortuosity, and Df were measured using semiautomated software from fundus images. The average retinal parameters were compared between the two groups. The receiver operation curve (ROC) was used to assess the diagnostic efficacy of various retinal vascular parameters for TAO.

Results

Despite controlling for potential confounding variables, Df, vessel width, and tortuosity significantly increased in TAO compared to healthy volunteers. Compared to active TAO, patients in the inactive phase had a larger retinal venous caliber (p < 0.05), but there was no difference in Df or arterial caliber. Moderate and severe cases had a higher Df compared with mild cases (EUGOGO guidelines). The area under the ROC for Df, tortuosity, and vascular caliber in the diagnosis of TAO was 0.904 (95% CI: 0.884–0.924), 0.638 (95% CI: 0.598–0.679), and 0.617 (95% CI: 0.576–0.658), respectively.

Conclusions

Due to its accessibility, affordability, and non-invasive nature, retinal vascular Df may serve as a surrogate marker for TAO and might be used to identify severe cases. With relatively high diagnostic performance, the Df is of some utility for the detection of TAO.

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Funding

This work was supported by the National Natural Science Foundation of China (82071005); and the Special Fund of the Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority, China (No. XTCX201824).

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Authors and Affiliations

  1. Beijing Tongren Eye Center, Beijing Ophthalmology & Visual Sciences Key Lab, Capital Medical University, Beijing Tongren Hospital, Beijing, China

    Xue Jiang, Li Dong & Dongmei Li

  2. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China

    Lihua Luo

  3. EVision Technology (Beijing) Co. LTD, Beijing, China

    Dengji Zhou & Saiguang Ling

Authors
  1. Xue Jiang
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  4. Dengji Zhou
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Contributions

X.J.: Funding acquisition, methodology, supervision, data curation, formal analysis, visualization and original draft writing. L.L., S.L. and D.Z.: Investigation, sample analysis, data curation, resources and review and editing of manuscript. D.L.: Conceptualization, funding acquisition, methodology, supervision, visualization and intellectual editing of manuscript. L.D.: original draft writing, manuscript preparation and final revisions. All authors contributed to the article and approved the submitted version.

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Correspondence to Dongmei Li.

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This study is based on the latest version of the Declaration of Helsinki. All participants obtained written informed consent, and the study was approved by the Ethics Committee of Beijing Tongren Hospital

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Jiang, X., Dong, L., Luo, L. et al. Artificial Intelligence-based quantitative evaluation of retinal vascular parameters in thyroid-associated ophthalmopathy. Endocrine (2024). https://doi.org/10.1007/s12020-023-03561-x

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