{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T11:35:05Z","timestamp":1767353705043,"version":"3.48.0"},"reference-count":52,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Thyroid eye disease (TED) can lead to structural and microvascular changes in the orbit and retina. This study aimed to investigate the associations between Clinical Activity Score (CAS), orbital magnetic resonance imaging (MRI) measurements, and retinal microvascular changes in TED patients. Methods: This cross-sectional study included 38 patients (76 eyes) with TED. Each patient underwent a comprehensive ophthalmological evaluation, CAS assessment, and a detailed medical history. Optical coherence tomography angiography (OCTA) was performed to quantify vessel density (VD) in the superficial and deep capillary plexus (SCP and DCP). Exophthalmos, extraocular muscle thickness and orbital fat thickness were measured on MRI scans to evaluate structural changes. Laboratory analyses included thyroid hormone levels, thyrotropin receptor antibodies (TRAb), anti-thyroid peroxidase antibodies (anti-TPO), and lipid profile. Results: Active TED patients (CAS \u2265 3) had significantly higher TRAb levels (p &lt; 0.001), while anti-TPO did not differ between groups. Active eyes showed significantly higher DCP VD in the whole image (p = 0.013), parafovea (p = 0.012), and perifovea (p = 0.009) across all quadrants, with no difference in SCP or the foveal avascular zone (FAZ). In linear mixed model regression analyses, after adjusting for previous glucocorticosteroid therapy, higher triglycerides, greater medial rectus thickness, and whole-image DCP VD independently predicted higher CAS values (R2 = 42, p &lt; 0.001). After adjusting for age and sex, CAS remained significantly positive predictor of DCP VD in the parafovea (R2 = 0.22, p &lt; 0.001). Conclusions: Changes in DCP VD reflect TED activity and structural orbital involvement.<\/jats:p>","DOI":"10.3390\/jcm15010323","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T11:11:46Z","timestamp":1767352306000},"page":"323","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retinal Microvascular and Orbital Structural Alterations in Thyroid Eye Disease"],"prefix":"10.3390","volume":"15","author":[{"given":"Vera","family":"Jelu\u0161i\u0107","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Hospital Center Osijek, 31000 Osijek, Croatia"},{"name":"Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivanka","family":"Maduna","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"Health Center of Osijek-Baranja County, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7269-3534","authenticated-orcid":false,"given":"Dubravka","family":"Biuk","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital Center Osijek, 31000 Osijek, Croatia"},{"name":"Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5832-1745","authenticated-orcid":false,"given":"Zdravka","family":"Krivdi\u0107 Dupan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"Department of Radiology, University Hospital Center Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josip","family":"Bara\u0107","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital Center Osijek, 31000 Osijek, Croatia"},{"name":"Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolina","family":"\u0160ilje\u0161","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital Center Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Jelu\u0161i\u0107","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Center Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1563-7974","authenticated-orcid":false,"given":"Tvrtka","family":"Bena\u0161i\u0107","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital Center Osijek, 31000 Osijek, Croatia"},{"name":"Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jelena","family":"Juri Mandi\u0107","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"},{"name":"Department of Ophthalmology, University Hospital Center Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1167\/iovs.65.5.6","article-title":"Deep-Learning Based Automated Segmentation and Quantitative Volumetric Analysis of Orbital Muscle and Fat for Diagnosis of Thyroid Eye Disease","volume":"65","author":"Alkhadrawi","year":"2024","journal-title":"Investig. 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