Update on non-radiologic ocular and orbital imaging in thyroid eye disease: a review
5 affiliations
- 1University of California, Irvine School of Medicine, Irvine, California, United States
- 2Gavin Herbert Eye Institute, Department of Ophthalmology and Visual Sciences, UC Irvine, Irvine, California, United States
- 3UC Irvine, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
- 4UC Irvine, Department of Biomedical Engineering, Irvine, California, United States
- 5Brunson Center for Translational Vision Research, UC Irvine, Irvine, California, United States
Abstract
Significance: Thyroid eye disease (TED) involves inflammatory, vascular, and fibrotic remodeling of periocular tissues that is traditionally characterized by clinical activity scores and, at times, by conventional neuroimaging. Emerging noninvasive imaging modalities are poised to enhance clinical assessment by objectively quantifying inflammation, vascular alterations, fibrosis, and changes in tissue architecture. These tissue biomarkers have the potential to improve prediction of disease progression and therapeutic response beyond what can be inferred from clinical activity scores alone.
Aim: This review synthesizes established and emerging periocular nonionizing imaging techniques for TED, including ultrasound-based methods, optical coherence tomography (OCT), confocal microscopy (CM), and spatial frequency domain imaging (SFDI).
Approach: Peer-reviewed studies evaluating human subjects with TED were reviewed to understand the technical aspects, advantages, limitations, and clinical relevance of each modality.
Results: Ultrasound elastography and high-frequency ultrasonography enable assessment of tissue stiffness, thickness, and vascularity but are limited by operator dependence and penetration depth. OCT and OCT-angiography provide high-resolution evaluation of retinal, choroidal, and anterior segment structural and vascular changes associated with orbital congestion. Confocal microscopy identifies anatomical alterations that differentiate active from inactive disease. SFDI enables wide-field, noncontact quantification of periocular optical properties, with preliminary findings suggesting sensitivity to inflammatory edema.
Conclusions: This review summarizes current and emerging imaging modalities used to provide quantitative, high-resolution assessment of structural and functional tissue changes in TED.
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BibTeX
@article{cho2026update,
title = {{Update on non-radiologic ocular and orbital imaging in thyroid eye disease: a review}},
author = {Hannah E. Cho and Christopher D. Yang and Miranda B. An and Gordon T. Kennedy and Bernard Choi and Anthony J. Durkin and Andrew W. Browne and Lilangi S. Ediriwickrema},
journal = {Journal of biomedical optics},
year = {2026},
month = oct,
doi = {10.1117/1.jbo.31.10.100902},
url = {https://europepmc.org/article/PMC/PMC13722106},
note = {CC BY},
}
RIS
TY - JOUR
TI - Update on non-radiologic ocular and orbital imaging in thyroid eye disease: a review
AU - Hannah E. Cho
AU - Christopher D. Yang
AU - Miranda B. An
AU - Gordon T. Kennedy
AU - Bernard Choi
AU - Anthony J. Durkin
AU - Andrew W. Browne
AU - Lilangi S. Ediriwickrema
PY - 2026
DA - 2026/10/01
JO - Journal of biomedical optics
DO - 10.1117/1.jbo.31.10.100902
UR - https://europepmc.org/article/PMC/PMC13722106
AB - Significance: Thyroid eye disease (TED) involves inflammatory, vascular, and fibrotic remodeling of periocular tissues that is traditionally characterized by clinical activity scores and, at times, by conventional neuroimaging. Emerging noninvasive imaging modalities are poised to enhance clinical assessment by objectively quantifying inflammation, vascular alterations, fibrosis, and changes in tissue architecture. These tissue biomarkers have the potential to improve prediction of disease progression and therapeutic response beyond what can be inferred from clinical activity scores alone. Aim: This review synthesizes established and emerging periocular nonionizing imaging techniques for TED, including ultrasound-based methods, optical coherence tomography (OCT), confocal microscopy (CM), and spatial frequency domain imaging (SFDI). Approach: Peer-reviewed studies evaluating human subjects with TED were reviewed to understand the technical aspects, advantages, limitations, and clinical relevance of each modality. Results: Ultrasound elastography and high-frequency ultrasonography enable assessment of tissue stiffness, thickness, and vascularity but are limited by operator dependence and penetration depth. OCT and OCT-angiography provide high-resolution evaluation of retinal, choroidal, and anterior segment structural and vascular changes associated with orbital congestion. Confocal microscopy identifies anatomical alterations that differentiate active from inactive disease. SFDI enables wide-field, noncontact quantification of periocular optical properties, with preliminary findings suggesting sensitivity to inflammatory edema. Conclusions: This review summarizes current and emerging imaging modalities used to provide quantitative, high-resolution assessment of structural and functional tissue changes in TED.
SN - 1083-3668
SN - 1560-2281
ER -