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New research · Ophthalmology
Orbit (Amsterdam, Netherlands) · 4d
Cohort studyOrbit (Amsterdam, Netherlands) · 2026

Anterior segment optical coherence tomography angiography in the evaluation of thyroid eye disease: a pilot study.

Swan Kang, Scott Hau, Victoria Barnett … Daniel Ezra
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OphthalmologyCohort study

Vessel density on eye imaging is higher in thyroid eye disease than in healthy eyes

Anterior segment optical coherence tomography angiography in the evaluation of thyroid eye disease: a pilot study.

Swan Kang … Daniel Ezra
Orbit (Amsterdam, Netherlands) · 2026
Background

Current grading systems for thyroid eye disease (thyroid eye disease) are subjective, highlighting the need for objective assessment tools.

Purpose

This pilot study evaluated whether anterior segment optical coherence tomography angiography (anterior segment optical coherence tomography angiography) can detect characteristic vasculature changes in thyroid eye disease.

Methods

A prospective comparative case series at Moorfields Eye Hospital included patients with thyroid eye disease and healthy controls.

n = 965 images
Results

vessel coverage in eye tissue was higher with thyroid eye disease than without

33.3%
TED
20.7%
Controls
More results

Thyroid eye disease patients had higher episcleral/scleral vessel density index than conjunctival epithelium; the inverse was observed in controls.

Active thyroid eye disease (CAS = 3-7) exhibited the highest vessel density index versus inactive thyroid eye disease (CAS = 0-2) and controls.

More results

Fractal dimension was higher in thyroid eye disease, increasing progressively from controls to inactive and active thyroid eye disease.

Four patients (6 eyes) underwent decompression surgery with non-significant reductions in vessel density index and fractal dimension.

“
Conclusion

Anterior segment optical coherence tomography angiography detects significant differences in vascular parameters between thyroid eye disease and healthy controls, supporting its potential as a non-invasive, quantitative adjunct in thyroid eye disease grading systems.

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