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Sio SWC, Chan BKT, Aljufairi FMAA, Sebastian JU, Lai KKH, Tham CCY, Pang CP, Chong KKL. Diagnostic methods for dysthyroid optic neuropathy: A systematic review and analysis. Surv Ophthalmol 2024; 69:403-410. [PMID: 38007201 DOI: 10.1016/j.survophthal.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
Diagnosis of dysthyroid optic neuropathy (DON) typically relies on a set of diagnostic clinical features, including decreased visual acuity, impaired color vision, presence of relative afferent pupillary defect, optic disc swelling and ancillary tests including visual field (VF), pattern visual evoked potential (pVEP), and apical crowding or optic nerve stretching on neuroimaging. We summarize various diagnostic methods to establish or rule out DON. A total of 95 studies (involving 4619 DON eyes) met the inclusion criteria. All of the studies considered clinical features as evidence of DON, while most of the studies confirmed DON diagnosis by combining clinical features with ancillary tests. Forty studies (42.1%) used at least 2 out of the 3 tests (VF, pVEP and neuroimaging) and 13 studies (13.7%) used all 3 tests to diagnose DON. In 64 % of the published studies regarding DON, the diagnostic methods of DON were not specified. It is important to note the limitations of relying solely on clinical features for diagnosing DON. On the other hand, since some eyes with optic neuropathy can be normal in one ancillary test, but abnormal in another, using more than one ancillary test to aid diagnosis is crucial and should be interpreted in correlation with clinical features. We found that the diagnostic methods of DON in most studies involved using a combination of specific clinical features and at least 2 ancillary tests.
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Affiliation(s)
- Stella Weng Chi Sio
- Hong Kong Eye Hospital, Hong Kong SAR, China; Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Benson Kang To Chan
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Fatema Mohamed Ali Abdulla Aljufairi
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Department of Ophthalmology, Salmaniya Medical Complex, Government Hospitals, Bahrain
| | - Jake Uy Sebastian
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Department of Ophthalmology, Vicente Sotto Memorial Medical Centre, Cebu City, the Philippines
| | - Kenneth Ka Hei Lai
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Clement Chee Yung Tham
- Hong Kong Eye Hospital, Hong Kong SAR, China; Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kelvin Kam Lung Chong
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China.
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Yan W, He Q, Chen M, Zhang S, Chen T, Zhang L, Wang H. SSFVEP as a potential electrophysiological examination for evaluating visual function of fundus diseases with vitreous hemorrhages: a clinical study. Sci Rep 2024; 14:2378. [PMID: 38287026 PMCID: PMC10825178 DOI: 10.1038/s41598-023-47714-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/17/2023] [Indexed: 01/31/2024] Open
Abstract
To investigate the sensitivity and potential application of steady-state flash visual evoked potentials (SSFVEP) in assessing the visual function of fundus diseases with vitreous hemorrhage. 18 patients diagnosed with monocular vitreous hemorrhages in the fundus were examined the flash visual evoked potentials (FVEP) and SSFVEP in both eyes. The difference in the P2-wave amplitude of FVEP and the average amplitude of SSFVEP waveform between the diseased eyes and those without vitreous hemorrhage were statistically compared. There was no significant difference in the waveform of FVEP between both eyes. The amplitude of P2-wave from FVEP of the diseased eye was slightly lower than that without vitreous hemorrhage. However, the difference was not statistically significant (P = 0.111). The waveform of SSFVEP in the eye without vitreous hemorrhage showed a towering shape, while that of the diseased eye was flat. The average amplitude of SSFVEP in the diseased eye was statistically lower than that without vitreous hemorrhage (P = 0.036). The difference ratio of SSFVEP amplitude between both eyes was significantly greater than that of FVEP amplitude (P = 0.028). In some fundus diseases with vitreous hemorrhage, SSFVEP had a higher sensitivity than FVEP, providing a novel potential application for visual function assessment.
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Affiliation(s)
- Weiming Yan
- The Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
- The Third Hospital of Zhangzhou, Zhangzhou, China
- Fuzong Clinical Medical College of Fujian Medical University, Dongfang Hopsital Affiliated to Xiamen University, Fuzhou, China
| | - Qiurui He
- The Third Hospital of Zhangzhou, Zhangzhou, China
| | - Meizhu Chen
- Fuzong Clinical Medical College of Fujian Medical University, Dongfang Hopsital Affiliated to Xiamen University, Fuzhou, China
| | - Sheng Zhang
- Fuzong Clinical Medical College of Fujian Medical University, Dongfang Hopsital Affiliated to Xiamen University, Fuzhou, China
| | - Tao Chen
- Center of Clinical Aerospace Medicine, Air Force Military Medical University, Xi'an, China
| | - Lei Zhang
- The Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
| | - Haiyan Wang
- The Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China.
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Liu P, Luo B, Feng Y, Chen L, Zhao YL, Wang QX, Liang SP, Wu HY, Yuan G, Jiang GH, Zhang J. Aberrant spontaneous brain activity in patients with thyroid-associated ophthalmopathy with and without optic neuropathy: a resting-state functional MRI study. Eur Radiol 2023; 33:7981-7991. [PMID: 37410107 DOI: 10.1007/s00330-023-09829-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 04/09/2023] [Accepted: 04/14/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES To investigate the brain functional alterations in dysthyroid optic neuropathy (DON) by evaluating spontaneous neural activity, using functional magnetic resonance imaging (fMRI) with regional homogeneity (ReHo), and its relationship with ophthalmologic performance. METHODS Forty-seven patients with thyroid-associated ophthalmopathy (TAO; 20 with DON, 27 with non-DON) and 33 age-, sex-, and education-matched healthy controls (HCs) underwent fMRI. ReHo values were compared using one-way analysis of variance (ANOVA) with post hoc pairwise comparisons (voxel-level p < 0.01, Gaussian random field correction, cluster-level p < 0.05). Correlations between ReHo values and ophthalmological metrics were assessed for DONs, with Bonferroni correction for multiple comparisons (p < 0.004). ROC curves were applied to evaluate the diagnostic performance of ReHo metrics. RESULTS ReHo values were significantly lower in the left insula and right superior temporal gyrus, and higher in the left posterior cingulate cortex (LPCC), of DON than of non-DON patients. ReHo values were also significantly lower in the right middle temporal, left insula, and left precentral gyrus in DON than in HCs. Meanwhile, ReHo values were higher in LPCC in non-DON than in HCs. ReHo values correlated with ophthalmic examinations to varying degrees in DON. For distinguishing DON, the ReHo values in LPCC showed optimal individually (AUC = 0.843), the combination of the ReHo in both the left insula and LPCC performed better (AUC = 0.915). CONCLUSION Spontaneous brain activity differed between TAO with and without DON, which may reflect the underlying pathological mechanism of DON. The ReHo index can be considered a diagnostic biomarker. CLINICAL RELEVANCE STATEMENT Spontaneous brain activity in DON differed from that in TAO without DON, which may reflect the underlying pathological mechanism of DON. The ReHo index can be considered a diagnostic biomarker for early detection of DON. KEY POINTS • Dysthyroid optic neuropathy (DON) affects brain activity, which contributes in the understanding of its visual dysfunction. • Regional homogeneity values differ between thyroid-associated ophthalmopathy with and without DON in various brain regions. • Regional homogeneity values can be used as a biomarker in the differential diagnosis of DON.
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Affiliation(s)
- Ping Liu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, #1095 Jiefang Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Ban Luo
- Department of Ophthalmology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ying Feng
- Department of Radiology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan Province, China
| | - Lang Chen
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, #1095 Jiefang Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Ya-Li Zhao
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, #1095 Jiefang Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Qiu-Xia Wang
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, #1095 Jiefang Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Si-Pei Liang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China
| | - Hong-Yu Wu
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, #1095 Jiefang Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Gang Yuan
- Department of Endocrinology and Metabolism, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Gui-Hua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jing Zhang
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, #1095 Jiefang Road, Wuhan, 430030, Hubei, People's Republic of China.
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Garip Kübler A, Halfter K, Reznicek L, Klingenstein A, Priglinger S, Rudolph G, Hintschich C. Evaluation of visual evoked potentials in dysthyroid optic neuropathy. Orbit 2023; 42:475-480. [PMID: 36128945 DOI: 10.1080/01676830.2022.2123929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate the findings of visual evoked potentials (VEP) in patients with dysthyroid optic neuropathy (DON). METHODS In this observational, cross-sectional study 40 eyes (22 patients) with a diagnosis of DON were included. RESULTS We discovered that in 16 out of 37 eyes with pattern-VEP (p-VEP), the latency of P100 wave was normal in spite of having a diagnosis of DON. The same pattern was also observed in the measurement of the amplitude of P100 wave: in 28 out of 37 eyes with p-VEP the amplitudes were observed as normal. In 3 eyes of 3 patients p-VEP showed no response, therefore a flash-VEP (f-VEP) was performed. Flash-VEPs of those patients indicated a prolonged P100 latency with a reduced amplitude. The sensitivity of abnormal P100 latency was 56.8% (95%CI 39.5-72.9%); and that of reduced P100 amplitude was 24.3% (95%CI 11.8-41.2%). Also, in 40 eyes color vision test by Arden was performed. In 36 eyes (20 patients) the tritan value was pathological (based on a threshold of ≥8%). CONCLUSION According our data, VEP seems to have a limited potential especially in patients with a good best-corrected visual acuity (BCVA ≤0.2 LogMAR) for identifying the optic nerve involvement. The fact that P100 latency and amplitude were normal even in cases with an optic nerve swelling makes us question the usefulness of the VEP for diagnosing cases of DON in daily clinical life.
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Affiliation(s)
- Aylin Garip Kübler
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - Kathrin Halfter
- Munich Cancer Registry, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Lukas Reznicek
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | | | | | - Günther Rudolph
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
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Liang J, Tian P, Wang J, Fan S, Deng X, Zhang J, Zhang J, Wang M, Zeng P. A diagnostic model based on color vision examination for dysthyroid optic neuropathy using Hardy-Rand-Rittler color plates. Graefes Arch Clin Exp Ophthalmol 2023; 261:2669-2678. [PMID: 37103624 DOI: 10.1007/s00417-023-06062-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/25/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023] Open
Abstract
PURPOSE To investigate color vision deficiency and the value of Hardy-Rand-Rittler (HRR) color plates in monitoring dysthyroid optic neuropathy (DON) to improve the diagnosis of DON. METHODS The participants were divided into DON and non-DON (mild and moderate-to-severe) groups. All the subjects underwent HRR color examination and comprehensive ophthalmic examinations. The random forest and decision tree models based on the HRR score were constructed by R software. The ROC curve and accuracy of different models in diagnosing DON were calculated and compared. RESULTS Thirty DON patients (57 eyes) and sixty non-DON patients (120 eyes) were enrolled. The HRR score was lower in DON patients than in non-DON patients (12.1 ± 6.2 versus 18.7 ± 1.8, p < 0.001). The major color deficiency was red-green deficiency in DON using HRR test. The HRR score, CAS, RNFL, and AP100 were found to be important factors in predicting DON from random forest and selected by decision tree to construct the multifactor model. The sensitivity, specificity, and the area under the curve (AUC) of the HRR score were 86%, 72%, and 0.87, respectively. The HRR score decision tree had a sensitivity, specificity, and AUC of 93%, 57%, and 0.75, respectively, with an accuracy of 82%. The data of the multifactor decision tree were 90%, 89%, and 0.93 for sensitivity, specificity, and AUC, respectively, with an accuracy of 91%. CONCLUSION The HRR test was valid as screening method for DON. The multifactor decision tree based on the HRR test improved the diagnostic efficacy for DON. An HRR score of less than 12 and red-green deficiency may be characteristic of DON.
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Affiliation(s)
- Jiaqi Liang
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Peng Tian
- Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Jing Wang
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Shuxian Fan
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Xiaowen Deng
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Jiafeng Zhang
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Jia Zhang
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Mei Wang
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China.
| | - Peng Zeng
- Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China.
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Luo B, Liu R, Wang S, Hu W, Li Y, Tong B, Zhang H, Qi X. Utility of isolated-check visual evoked potential technique in dysthyroid optic neuropathy. Graefes Arch Clin Exp Ophthalmol 2023; 261:2031-2040. [PMID: 36642765 PMCID: PMC10271890 DOI: 10.1007/s00417-023-05975-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 12/13/2022] [Accepted: 01/03/2023] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To analyze the utility of isolated-check visual evoked potential (icVEP) for discriminating between eyes with dysthyroid optic neuropathy (DON) and eyes with thyroid-associated ophthalmopathy (TAO) but not DON. METHODS Forty-three eyes with TAO but not DON (as non-DON), fifty-three eyes with DON, and sixty healthy eyes (as controls) were included. Comprehensive ophthalmic examinations, including best-corrected visual acuity, refraction, color vision test, intraocular pressure measurement, slit-lamp biomicroscopy, ophthalmoscopy, RAPD, exophthalmometry measurements, pVEP test, icVEP test, standard automated perimetry, and clinical activity score classification of TAO, as well as demographic information, were collected and analyzed. RESULTS In the DON group, the signal-to-noise ratio (SNR) value of icVEPs decreased significantly compared with that of the non-DON group as well as control (p < 0.05). The SNR values under 8%, 16% and 32% depth of modulation (DOM) were significantly negatively correlated with BCVA (p < 0.05, r = - 0.9 ~ - 0.6), papilledema (Y/N) (p < 0.05, r = - 0.8 ~ 0.4) and DON (Y/N) (p < 0.001, r = - 0.7 ~ - 0.5). The 8% DOM of icVEP had the largest area under the receiver operating characteristic curve (AUC) (0.842) for discriminating DON from non-DONs. Meanwhile, decision curve analysis (DCA) showed that patients clinically benefit most from 8% DOM of icVEP. Furthermore, the 8% DOM of icVEP combing with papilledema (Y/N) and BCVA (Model 1) has significantly larger AUC than the 8% DOM of icVEP (p = 0.0364), and has better clinical benefit in DCA analysis. CONCLUSIONS The SNR of 8% DOM from icVEP may represent a significant ancillary diagnostic method for DON detection. Furthermore, icVEP combined with papilledema (Y/N) and BCVA should be considered as a diagnostic model in future clinical practice.
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Affiliation(s)
- Ban Luo
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Qiaokou District, No.1095, Jiefang Avenue, Wuhan, 430030 Hubei China
- Department of Ophthalmology, Wenchang People’s Hospital, Wenchang, 571321 China
| | - Rong Liu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Qiaokou District, No.1095, Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Shanluxi Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Qiaokou District, No.1095, Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Weikun Hu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Qiaokou District, No.1095, Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Yunping Li
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, No.139, Renmin Middle Road, Changsha, 410011 Hunan China
| | - Boding Tong
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, No.139, Renmin Middle Road, Changsha, 410011 Hunan China
| | - Hong Zhang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Qiaokou District, No.1095, Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Xin Qi
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, No.139, Renmin Middle Road, Changsha, 410011 Hunan China
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Wang X, Fang Y, Li R, Pan Y. Diagnostic Capability of Isolated-Check Visual Evoked Potential for Early to Moderate Primary Open-Angle Glaucoma. Life (Basel) 2023; 13:1257. [PMID: 37374038 DOI: 10.3390/life13061257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
This study aimed to evaluate the diagnostic capability of isolated-check visual evoked potential (icVEP) for primary open-angle glaucoma (POAG) via comparison with visual field (VF) tests and pattern visual evoked potential (PVEP). This cross-sectional study enrolled 68 subjects, including 33 POAG patients and 35 controls. All subjects underwent a complete ophthalmic examination, including icVEP, PVEP, and VF tests. The diagnostic performance, the area under the receiver operating characteristic curve (AUC), the integrated discrimination index (IDI), and the net reclassification index (NRI) were calculated. The clinical benefits of the three tests were compared via decision curve analysis (DCA) of the signal-to-noise ratio (SNR) from icVEP, the P100 latency and amplitude of 1° and 0.25° checks from the PVEP, pattern standard deviation (PSD), and mean deviation (MD) from the VF test. The SNR, MD and PSD, PVEP P100 latency of 0.25° checks, and P100 amplitude (both 1° and 0.25° checks) showed significant differences between the POAG and control groups (* p < 0.05), except for the P100 latency of 1° checks. Regarding diagnostic ability, the three tests, AUC, IDI, and NRI, showed no significant difference (p > 0.05). The DCA showed that the clinical benefits of icVEP (SNR) were comparable to those of VF (MD and PSD) and better than those of PVEP (P100 latency and amplitude). In addition, no significant difference was found in the consistency analysis of the qualitative comparison between the icVEP, VF, and PVEP (McNemar p > 0.05). In this study, icVEP showed a diagnostic ability for early to moderate POAG patients comparable to VF and PVEP. IcVEP might be applied as a supplementary psychophysical examination method in addition to VF examinations for special POAG populations who have difficulty cooperating with the VF examination.
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Affiliation(s)
- Xia Wang
- Department of Ophthalmology, Peking University First Hospital, Beijing 100034, China
| | - Yuan Fang
- Department of Ophthalmology, Peking University First Hospital, Beijing 100034, China
| | - Ruoshi Li
- Department of Ophthalmology, Peking University First Hospital, Beijing 100034, China
| | - Yingzi Pan
- Department of Ophthalmology, Peking University First Hospital, Beijing 100034, China
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Liu P, Luo B, Chen L, Wang QX, Zhai LH, Wu HY, Zhao YL, Yuan G, Jiang GH, Zhang J. Preliminary Diffusion-Tensor Imaging Evidence for Trans-Synaptic Axonal Degeneration in Dysthyroid Optic Neuropathy Due to Thyroid-Associated Ophthalmopathy. J Magn Reson Imaging 2023; 57:834-844. [PMID: 35864716 DOI: 10.1002/jmri.28352] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The mechanism driving dysthyroid optic neuropathy (DON) is unclear. Diffusion-tensor imaging (DTI) allows for noninvasively assessing the microstructure of the entire visual pathway and may facilitate a better understanding of the mechanism of DON. PURPOSE To assess microstructural changes of the whole visual pathway and to investigate the potential mechanism of trans-synaptic damage(TSD) pathogenesis in DON with DTI. STUDY TYPE Cross-sectional. POPULATION Sixty-four patients with bilateral thyroid-associated ophthalmopathy (TAO), 30 with and 34 without DON, and 30 age- and sex-matched healthy controls (HCs). FIELD STRENGTH/SEQUENCE 3 T/DTI (A single-shot diffusion-weighted echo-planar imaging sequence). ASSESSMENT Differences in DTI parameters including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in each segment (optic nerve, tract, and radiation) of the entire visual pathway among the groups were compared. The parameters of visual evoked potentials (VEPs), visual field tests, and mean retinal nerve fiber layer (mRNFL) thickness on optical coherence tomography were also compared across patients. STATISTICAL TESTS Student's t-test, chi-square test; ANOVA with post-hoc testing, interclass correlation coefficient, and correlation analysis. Significance level: P < 0.05. RESULTS TAO patients with DON showed significantly reduced mRNFL thickness and abnormal VEPs. There was a tendency for gradually reduced FA and AD, and increased RD and MD from HCs, with non-DON to with DON in optic nerve and tract, statistically. For radiation, the RD and MD showed statistical increase, the AD and FA just showed numerical decrease (P = 0.119 and 0.059, respectively). For DON, the FA and MD of visual pathway segments showed correlations with abnormal VEPs. DATA CONCLUSION DTI may be a useful tool for detecting microstructural changes in the entire visual pathway in DON. The changes in RNFL thickness and DTI parameters suggested TSD as a potential pathogenic mechanism of DON. EVIDENCE LEVEL 4 Technical Efficacy: Stage 5.
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Affiliation(s)
- Ping Liu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China.,Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ban Luo
- Department of Ophthalmology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Lang Chen
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Qiu-Xia Wang
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Lin-Han Zhai
- Department of Radiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Hong-Yu Wu
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ya-Li Zhao
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Gang Yuan
- Department of Endocrinology and Metabolism, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Gui-Hua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jing Zhang
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
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