Dysthyroid optic neuropathy: a clinical diagnosis or a definable entity?

Dayan, Colin; Dayan, Margaret

doi:10.1136/bjo.2006.110932

Cited by 41 publications

(45 citation statements)

References 8 publications

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“…Careful clinical evaluation and follow-up of patients with GO is crucial. Dayan and Dayan [27] drew similar conclusions in their study previously presented in a simple diagnostic algorithm for DON. Special attention must be paid, especially in those with these pre-existing conditions, given their higher risk of developing DON later in life.…”

Section: Discussionsupporting

confidence: 59%

Prevalence of Radiological Signs of Dysthyroid Optic Neuropathy in Magnetic Resonance Imaging in Patients with Active, Moderate-to-Severe, and Very Severe Graves Orbitopathy

Rutkowska-Hinc¹,

Maj²,

Jabłońska³

et al. 2018

Eur Thyroid J

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Background: Differentiating between dysthyroid optic neuropathy (DON), which requires urgent therapy to prevent blindness, and moderate-to-severe Graves orbitopathy (GO) remains challenging. There is no pathognomonic feature of DON in either ophthalmological or radiological examinations. Objectives: Our aim was to investigate the prevalence of radiological signs of DON in magnetic resonance imaging (MRI) in patients with moderate-to-severe and very severe GO. Methods: Two researchers reassessed MRI scans of 23 consecutive patients (46 eyes) with active, moderate-to-severe GO and 14 patients (23 eyes) with very severe GO. Typical signs of DON in MRI include apical crowding and optic nerve stretching. These were evaluated in the eyes of both groups of patients. Lack of cerebrospinal fluid in the optic nerve sheath as well as muscle index values were also studied. These clinical evaluations and laboratory results were then compared between groups. Results: At least one of the typical radiological features of DON was found in 22 (96%) and 16 (35%) eyes with very severe and moderate-to-severe GO, respectively. Each occurred statistically more often in patients with very severe GO. There were no ophthalmological signs of very severe GO observed in the group of patients with moderate-to-severe GO during the study or its subsequent follow-up (234 weeks). Conclusions: MRI is a useful tool in evaluating very severe GO. However, features typical for DON are also found in up to 35% of eyes in patients with active, moderate-to-severe GO. Therefore, ophthalmological evaluation seems to be most important in the recognition of very severe GO.

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Section: Discussionsupporting

confidence: 59%

Prevalence of Radiological Signs of Dysthyroid Optic Neuropathy in Magnetic Resonance Imaging in Patients with Active, Moderate-to-Severe, and Very Severe Graves Orbitopathy

Rutkowska-Hinc¹,

Maj²,

Jabłońska³

et al. 2018

Eur Thyroid J

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“…In Graves' ophthalmopathy, the inflammatory cells occur in the orbital tissues and in the surrounding extraocular muscles (Tachibana et al, 2010;Dayan et Dayan, 2007). The present study data are similar to Murakami Y et al (2001), Petrović M J et al (2012) and our studies (Imbrasiene et al, 2010).…”

Section: Resultssupporting

confidence: 82%

Assessment of Medial and Inferior Extraocular Muscle Thickness by Ultrasonography in Juvenile Patients with Graves’ Disease

Imbrasienė¹,

Jarušaitienė²,

Jankauskienė³

2014

RADI

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In juvenile patients with Graves' disease, extraocular muscles may be involved. Ultrasonography is a very important and informative diagnostic method in patients with exophthalmos and Graves' disease. The aim of our study was to evaluate medial and inferior extraocular muscle thickness in juvenile patients with Graves' disease. Materials and methods: Ultrasonography was performed on 78 orbits of 39 juvenile patients with Graves' disease. The thickness of medial and inferior extraocular muscle was measured. 60 orbits of 30 randomly selected normal healthy volunteers aged 7 to 33 years were evaluated in the study. The mean values of proptosis, extraocular muscle thickness were compared between the patients and the normal subjects (Student's t-test). The significant level p<0.05 was considered statistically significant. Results: The study revealed that the thickness values of extraocular medial and inferior rectus muscles in juvenile patients with Graves' disease were significantly higher than in normal healthy subjects. Conclusions: The results of ultrasound investigation showed significant enlargement of medial and inferior extraocular muscle thickness in juvenile patients with Graves' disease. The data showed that ultrasonography is important in the evaluation of the thickness of medial and inferior extraocular muscle in Graves' disease.

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“…However, other concomitant ocular conditions may also affect VEPs, likely resulting in a much lower diagnostic specifi city of the test under normal conditions. 26,27 A recent study also found a signifi cant false-negative rate associated with the use of VEPs in patients with DON. 28 Despite all the above-mentioned clinical and imaging fi ndings there remains a large number of cases in which VF examination is still of invaluable importance for the diagnosis and management of patients with DON.…”

Section: Discussionmentioning

confidence: 95%

Using frequency-doubling perimetry to detect optic neuropathy in patients with Graves’ orbitopathy

et al. 2008

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Dysthyroid optic neuropathy: a clinical diagnosis or a definable entity?

Cited by 41 publications

References 8 publications

Prevalence of Radiological Signs of Dysthyroid Optic Neuropathy in Magnetic Resonance Imaging in Patients with Active, Moderate-to-Severe, and Very Severe Graves Orbitopathy

Prevalence of Radiological Signs of Dysthyroid Optic Neuropathy in Magnetic Resonance Imaging in Patients with Active, Moderate-to-Severe, and Very Severe Graves Orbitopathy

Assessment of Medial and Inferior Extraocular Muscle Thickness by Ultrasonography in Juvenile Patients with Graves’ Disease

Using frequency-doubling perimetry to detect optic neuropathy in patients with Graves’ orbitopathy

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