Changes in corneal and lenticular transparency in active and inactive Graves' Ophthalmopathy: a comparative densitometric study

Purpose: The aim of this study was to compare corneal and lens densitometry (CD and LD) values between active and inactive Graves Ophthalmopathy (GO) and Grave’s Disease (GD) patients without ophthalmic involvement and healthy controls. Methods: This cross-sectional clinical study included 22 patients with active GO with bilateral ocular involvement (group 1), 36 patients with inactive GO (group 2), 54 patients with GD but without ophthalmopathy (group 3) and 30 age- and gender-matched healthy controls (group 4). All participants underwent comprehensive ophthalmic examination, followed by corneal and lens densitometry assessment using the Pentacam HR imaging system (Oculus Inc., Wetzlar, Germany). Results: Comparative analysis revealed statistically significant differences (p < 0.05) in CD values among the groups across all layers, except for the anterior 10–12 mm (p = 0.117), posterior 0–2 mm (p = 0.185), and posterior 2–6 mm zones (p = 0.099). Active GO patients showed the highest CD values, followed by inactive GO, non-ophthalmopathy GD patients, and healthy controls, respectively. Additionally, CD-mean, CD-SD and CD-max parameters showed statistically significant differences between the groups (all p < 0.05), with active GO demonstrating significantly higher values than other groups. Regarding LD, LD-mean, LD-SD, and LD-max values were significantly higher in all Grave’s disease–related groups compared with the control group (p < 0.001). Conclusıon: Our study shows that lenticular and corneal clarity is significantly reduced in GO patients, especially during the active period. These findings suggest that Pentacam could be used as a rapid, reliable and non-invasive tool for the early detection of deterioration in corneal and lenticular transparency in these patients.