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 McKeag, David
A1 Lane, Carol
A1 Lazarus, John H
A1 Baldeschi, Lelio
A1 Boboridis, Kostas
A1 Dickinson, A Jane
A1 Hullo, A Iain
A1 Kahaly, George
A1 Krassas, Gerry
A1 Marcocci, Claudio
A1 Marinò, Michele
A1 Mourits, Maarten P
A1 Nardi, Marco
A1 Neoh, Christopher
A1 Orgiazzi, Jacques
A1 Perros, Petros
A1 Pinchera, Aldo
A1 Pitz, Susanne
A1 Prummel, Mark F
A1 Sartini, Maria S
A1 Wiersinga, Wilmar M
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.