Correlation of peripapillary nerve fiber layer thickness with visual outcomes after decompression surgery in subclinical and clinical thyroid-related compressive optic neuropathy

Abstract

Purpose To assess the correlation of peripapillary retinal nerve fiber layer (PRNFL) thickness with visual recovery in compressive optic neuropathy (CON) in patients with thyroid eye disease (TED). Methods Twenty-three eyes of 13 consecutive patients with TED-related CON were prospectively recruited. Assessment of PRNFL by means of spectral domain optical coherence tomography (SD-OCT), visual field (VF) parameters, color vision, and visual acuity in logMAR were compared before and 6 months after decompression surgery in the operated eye for each patient, which in ten cases included both eyes. Decompression surgery was performed as medial and inferior wall decompression sparing the orbital strut by the same surgeon. Results There was a significant correlation between the preoperative PRNFL average thickness and postoperative improvement in visual acuity among all patients ( P = 0.048). This correlation was found to be significant in clinically non-edematous optic neuropathy cases ( P = 0.023) but not in edematous optic neuropathy ( P = 0.23). There was significant correlation between PRNFL thickness and improvement of postoperative mean deviation (MD) and pattern standard deviation (PSD) parameters in VF studies and in color vision scores ( P = 0.005, P = 0.02, P = 0.01, respectively). Average PRNFL thickness and quadrantal PRNFL were all significantly reduced after decompression surgery in all of the cases ( P = 0.024). Conclusions PRNFL thickness measured by SD-OCT is correlated with visual recovery after decompression surgery in TED-related CON. In eyes with severe VF defect (MD worse than −10 dB), the ones with higher preoperative PRNFL thicknesses (>65 μm) had more improvement in MD compared with those with thin PRNFL measures (<60 μm).

Recent advances and future directions on the use of optical coherence tomography in neuro-ophthalmology

“…[ 99 ] There is emerging evidence to suggest in some cases that nasal GCIPL thickness may have superior prognostic power to the RNFL in postoperative visual outcomes in sellar tumours. [ 100 ]…”

Kết quả bước đầu phẫu thuật nội soi giảm áp hốc mắt điều trị bệnh mắt Basedow chèn ép thị thần kinh

“…Liang (2019) hồi cứu trên 30 mắt và Rajabi (2018) nghiên cứu tiến cứu trên 23 mắt có DON được phẫu thuật giảm áp khác nhau cũng có nhận định rằng thị lực trước mổ càng tốt tương quan với thị lực sau mổ càng tốt. 13,14 Cơ chế chèn ép dây thần kinh thị giác dẫn đến giảm thị lực vẫn chưa hoàn toàn sáng tỏ.…”

A Pilot Study of Subclinical Non-Capillary Peripapillary Perfusion Changes in Thyroid-Related Orbitopathy Detected Using Optical Coherence Tomography Angiography

“…Dysthyroid optic neuropathy (DON), occurring in about 4–8% of TRO cases, is the most serious vision-threatening complication, 3 and is preventable and potentially reversible if detected early. 4 A number of possible mechanisms have been proposed in DON. Anatomic crowding from muscle enlargement at the annulus of Zinn in the orbital apex may lead to compression of the optic nerve, 5 causing axoplasmic stasis and decreased axonal functionality.…”