RT Journal Article
SR Electronic
T1 Clinical features of dysthyroid optic neuropathy: a European Group on Graves’ Orbitopathy (EUGOGO) survey
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 455
OP 458
DO 10.1136/bjo.2006.094607
VO 91
IS 4
A1 David McKeag
A1 Carol Lane
A1 John H Lazarus
A1 Lelio Baldeschi
A1 Kostas Boboridis
A1 A Jane Dickinson
A1 A Iain Hullo
A1 George Kahaly
A1 Gerry Krassas
A1 Claudio Marcocci
A1 Michele Marinò
A1 Maarten P Mourits
A1 Marco Nardi
A1 Christopher Neoh
A1 Jacques Orgiazzi
A1 Petros Perros
A1 Aldo Pinchera
A1 Susanne Pitz
A1 Mark F Prummel
A1 Maria S Sartini
A1 Wilmar M Wiersinga
YR 2007
UL http://bjo.bmj.com/content/91/4/455.abstract
AB Background: This study was performed to determine clinical features of dysthyroid optic neuropathy (DON) across Europe. Methods: Forty seven patients with DON presented to seven European centres during one year. Local protocols for thyroid status, ophthalmic examination and further investigation were used. Each eye was classified as having definite, equivocal, or no DON. Results: Graves’ hyperthyroidism occurred in the majority; 20% had received radioiodine. Of 94 eyes, 55 had definite and 17 equivocal DON. Median Clinical Activity Score was 4/7 but 25% scored 3 or less, indicating severe inflammation was not essential. Best corrected visual acuity was 6/9 (Snellen) or worse in 75% of DON eyes. Colour vision was reduced in 33 eyes, of which all but one had DON. Half of the DON eyes had normal optic disc appearance. In DON eyes proptosis was > 21 mm (significant) in 66% and visual fields abnormal in 71%. Orbital imaging showed apical muscle crowding in 88% of DON patients. Optic nerve stretch and fat prolapse were infrequently reported. Conclusion: Patients with DON may not have severe proptosis and orbital inflammation. Optic disc swelling, impaired colour vision and radiological evidence of apical optic nerve compression are the most useful clinical features in this series.