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. 2025 Jul 1;25(1):361.
doi: 10.1186/s12886-025-04184-8.

Effects of pulse glucocorticoid treatment on retinal blood flow in patients with active Graves' orbitopathy

Hedayatullah Mohammadi  1 , İrfan Botan Güneş  2 , Şeyhmus Arı  3
Affiliations

Effects of pulse glucocorticoid treatment on retinal blood flow in patients with active Graves' orbitopathy

Hedayatullah Mohammadi et al. BMC Ophthalmol. .

Abstract

Background: Various studies have shown decreased retinal blood flow in patients with active Graves' orbitopathy (GO). We investigated whether retinal blood flow returned to normal levels after intravenous glucocorticoid treatment in active GO patients.

Methods: Thirty-two eyes of 32 patients with moderate or severe active GO and 32 eyes of 32 healthy participants were included. The blood flow in the superficial plexus (SP), deep retinal plexus (DP), external retinal (ER) capillary plexus and choriocapillaris was measured via OCT-Angiography before treatment with methylprednisolone and one week after the completion of treatment. In addition, central macular thickness, intraocular pressure, and best corrected visual acuity, were compared with those of the control group.

Results: Retinal blood flow (RBF) in the macula at SP, DP, ER and choriocapillaris levels was 48.38 ± 2.04, 54.17 ± 3.11, 0.42 ± 0.14 and 2176.45 ± 147.53 in the control group and 45.91 ± 4.56, 51.55 ± 3.84, 0.35 ± 0.34 and 2030.15 ± 132.15 in the active GO group, respectively. The RBF was significantly lower in the active GO group than in the control group at all angiographic levels (p < 0.001). Although blood flow increased after treatment, it remained lower than that in the control group (p < 0.001). The mean CMT was significantly greater in active GO patients before treatment than in the controls and after treatment (p < 0.001). No serious systemic or ocular side effects were observed in any of the patients.

Conclusions: After pulse glucocorticoid treatment, retinal blood flow increases but remains low compared with that in the healthy control group.

Keywords: Glucocorticoids; Graves’ ophthalmopathy; Optical coherence tomography angiography; Pulse therapy; Vessel, retinal blood.

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Conflict of interest statement

Declarations. Ethics approval: For the present study, approval was obtained from the Local Ethics Committee for Clinical Practices of Gaziantep University (Reg. number: 07/25/2021 − 205) under the 1961 Declaration of Helsinki and its later amendments. Informed consent was obtained from all individual participants included in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Optical coherence tomography angiography (OCT-A) image showing a 3 × 3 mm macular area centered on the fovea
Fig. 2
Fig. 2
Optical coherence tomography angiography (OCT-A) image showing a 4.5 × 4.5 mm region of the peripapillary area centered on the optic disc
See this image and copyright information in PMC

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