Systemic Vascular Contributions to Inactive Dysthyroid Optic Neuropathy: Beyond Mechanical Compression
- 1State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- 2Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
- 3Shaoxing Shangyu District Hospital of Traditional Chinese Medicine, Shaoxing, China
Abstract
Purpose: To investigate systemic vascular contributions—spanning microvascular, macrovascular, and molecular levels—to inactive dysthyroid optic neuropathy (DON) beyond the traditional model of mechanical compression.
Methods: This cross-sectional comparative study enrolled 52 patients with thyroid-associated ophthalmopathy (TAO), categorized into DON (n = 32) and non-DON (n = 20) groups with comparable orbital apex crowding, and 23 healthy controls. Participants underwent optical coherence tomography angiography (OCTA) to assess superficial macular vessel density (mVD). Systemic macrovascular status was evaluated via internal carotid artery calcification (ICAC) on computed tomography and pulse pressure (PP). Molecular assessments included blood lipids and endothelial injury markers, specifically nitric oxide (NO).
Results: Patients with inactive DON exhibited significant microvascular rarefaction, with reduced mVD compared to both controls and non-DON patients (P < 0.002). DON was also associated with a higher prevalence of macrovascular pathology, including ICAC (48.3% vs. 21.7%; P = 0.017) and elevated PP (P = 0.001). At the molecular level, DON was linked to dyslipidemia (elevated triglycerides, P = 0.001; reduced high-density lipoprotein, P = 0.014) and endothelial dysfunction (lower NO; P = 0.033). Reduced mVD correlated significantly with both ICAC and PP (P < 0.033), linking systemic and ocular vascular injury.
Conclusions: Inactive DON was associated with abnormalities across retinal microvascular, systemic macrovascular, and circulating biomarker domains. These findings support further investigation of a model in which systemic vascular vulnerability may interact with local orbital compression.
Translational Relevance: Assessment of systemic vascular risk may complement conventional orbital evaluation in patients with DON. Prospective studies are required to determine whether optimization of thyroid and vascular status can improve prevention or treatment.
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BibTeX
@article{liu2026systemic,
title = {{Systemic Vascular Contributions to Inactive Dysthyroid Optic Neuropathy: Beyond Mechanical Compression}},
author = {Weijie Liu and Mengting Wang and Hongxiao Jiang and Lu Chen and Xiaozhou Hu and Jie Ye and Wei Rao and Jiayi Zhang and Wentao Yan and Wencan Wu and Yunhai Tu},
journal = {Translational Vision Science \& Technology},
year = {2026},
month = oct,
doi = {10.1167/tvst.15.10.29},
url = {https://doi.org/10.1167/tvst.15.10.29},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Systemic Vascular Contributions to Inactive Dysthyroid Optic Neuropathy: Beyond Mechanical Compression
AU - Weijie Liu
AU - Mengting Wang
AU - Hongxiao Jiang
AU - Lu Chen
AU - Xiaozhou Hu
AU - Jie Ye
AU - Wei Rao
AU - Jiayi Zhang
AU - Wentao Yan
AU - Wencan Wu
AU - Yunhai Tu
PY - 2026
DA - 2026/10/19
JO - Translational Vision Science & Technology
DO - 10.1167/tvst.15.10.29
UR - https://doi.org/10.1167/tvst.15.10.29
AB - Purpose: To investigate systemic vascular contributions—spanning microvascular, macrovascular, and molecular levels—to inactive dysthyroid optic neuropathy (DON) beyond the traditional model of mechanical compression. Methods: This cross-sectional comparative study enrolled 52 patients with thyroid-associated ophthalmopathy (TAO), categorized into DON (n = 32) and non-DON (n = 20) groups with comparable orbital apex crowding, and 23 healthy controls. Participants underwent optical coherence tomography angiography (OCTA) to assess superficial macular vessel density (mVD). Systemic macrovascular status was evaluated via internal carotid artery calcification (ICAC) on computed tomography and pulse pressure (PP). Molecular assessments included blood lipids and endothelial injury markers, specifically nitric oxide (NO). Results: Patients with inactive DON exhibited significant microvascular rarefaction, with reduced mVD compared to both controls and non-DON patients (P < 0.002). DON was also associated with a higher prevalence of macrovascular pathology, including ICAC (48.3% vs. 21.7%; P = 0.017) and elevated PP (P = 0.001). At the molecular level, DON was linked to dyslipidemia (elevated triglycerides, P = 0.001; reduced high-density lipoprotein, P = 0.014) and endothelial dysfunction (lower NO; P = 0.033). Reduced mVD correlated significantly with both ICAC and PP (P < 0.033), linking systemic and ocular vascular injury. Conclusions: Inactive DON was associated with abnormalities across retinal microvascular, systemic macrovascular, and circulating biomarker domains. These findings support further investigation of a model in which systemic vascular vulnerability may interact with local orbital compression. Translational Relevance: Assessment of systemic vascular risk may complement conventional orbital evaluation in patients with DON. Prospective studies are required to determine whether optimization of thyroid and vascular status can improve prevention or treatment.
SN - 2164-2591
ER -