Systemic Inflammation, Thyroid Autoimmunity and Neuroretinal Changes in Graves Disease

Relationship Between Systemic Inflammation, Thyroid Autoimmunity, and Neuroretinal Structures in Graves Disease

This retrospective observational study aims to evaluate the relationship between systemic inflammatory parameters, thyroid autoimmunity markers, and neuroretinal structures in patients with Graves disease. Medical records of patients diagnosed with Graves disease and healthy control subjects evaluated at Elazığ Fethi Sekin City Hospital between August 2018 and January 2026 will be reviewed. Optical coherence tomography (OCT) measurements, including macular thickness and peripapillary retinal nerve fiber layer (RNFL) thickness, will be analyzed. Laboratory parameters such as complete blood count-derived inflammatory indices, C-reactive protein, thyroid function tests, and thyroid autoantibodies will also be recorded. The study will compare neuroretinal parameters between healthy controls, Graves disease patients without ophthalmopathy, and Graves disease patients with ophthalmopathy, and will investigate potential associations between systemic inflammation, thyroid autoimmunity, and neuroretinal structural changes.

Study Overview

• Status: Recruiting
• Conditions: Graves Ophthalmopathy; Graves Disease

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

• Study Contact: Name: SİNEM KESER, MD; Phone Number: +905070646384; Email: kesersinem@hotmail.com

Study Locations

• Turkey (Türkiye)
  • Elaziğ
    • Elâzığ, Elaziğ, Turkey (Türkiye)
      • Recruiting
      • Fethi Sekin City Hospital
      • Contact: SİNEM KESER, MD; Phone Number: +905070646384; Email: kesersinem@hotmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of adult patients diagnosed with Graves' disease who are followed in the endocrinology and ophthalmology clinics of the participating institution. Patients who meet the inclusion criteria and have available optical coherence tomography (OCT) measurements and laboratory data will be included in the patient group.

The control group will consist of age- and sex-matched healthy volunteers without a history of thyroid disease or ocular pathology, recruited from individuals undergoing routine ophthalmologic examination.

All participants will be evaluated for neuroretinal structural parameters using OCT and systemic inflammatory markers obtained from laboratory tests.

Description

Inclusion Criteria:

• Age ≥ 18 years

Diagnosis of Graves' disease (for the patient group)

No known thyroid disease in healthy control participants

Availability of optical coherence tomography (OCT) measurements and laboratory data

Time interval between OCT examination and blood sampling ≤ 10 days

Exclusion Criteria:

• Presence of glaucoma, optic neuropathy, or retinal vascular diseases

Macular diseases, uveitis, or severe refractive error (high myopia >6 diopters)

Diabetic retinopathy

History of previous intraocular surgery

History of active infection, malignancy, or systemic inflammatory disease

Poor-quality OCT measurements (segmentation errors or low signal strength)

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort
Healthy Controls; Age-matched healthy individuals without known thyroid disease or autoimmune disorders who underwent ophthalmologic examination and optical coherence tomography evaluation.
Graves Disease Without Ophthalmopathy; Patients diagnosed with Graves disease who do not have clinical signs of Graves ophthalmopathy and who underwent optical coherence tomography evaluation.
Graves Disease With Ophthalmopathy; Patients diagnosed with Graves disease who have clinical findings consistent with Graves ophthalmopathy and who underwent optical coherence tomography evaluation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Peripapillary Retinal Nerve Fiber Layer Thickness	Evaluation and comparison of peripapillary retinal nerve fiber layer thickness values in different quadrants among study groups.	Retrospective evaluation of OCT measurements obtained between August 2018 and January 2026
Macular Thickness Measured by Optical Coherence Tomography	Comparison of macular thickness measurements among healthy controls, Graves disease patients without ophthalmopathy, and Graves disease patients with ophthalmopathy.	Retrospective evaluation of OCT measurements obtained between August 2018 and January 2026

Collaborators and Investigators

• Sponsor: Elazıg Fethi Sekin Sehir Hastanesi

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2026
• Primary Completion (Estimated): April 1, 2026
• Study Completion (Estimated): May 1, 2026

Study Registration Dates

• First Submitted: March 14, 2026
• First Submitted That Met QC Criteria: March 14, 2026
• First Posted (Actual): March 18, 2026

Study Record Updates

• Last Update Posted (Actual): March 18, 2026
• Last Update Submitted That Met QC Criteria: March 14, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Optical coherence tomography; Systemic inflammation; Retinal nerve fiber layer; Graves disease; Graves ophthalmopathy; Thyroid autoimmunity
• Additional Relevant MeSH Terms: Endocrine System Diseases; Genetic Diseases, Inborn; Autoimmune Diseases; Immune System Diseases; Eye Diseases; Eye Diseases, Hereditary; Exophthalmos; Orbital Diseases; Goiter; Hyperthyroidism; Thyroid Diseases; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Graves Ophthalmopathy; Graves Disease
• Other Study ID Numbers: FSCH-2026-24-07

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No