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Predictive parameters on CT scan for dysthyroid optic neuropathy.

AIM: To evaluate the value of parameters on CT scan in predicting dysthyroid optic neuropathy (DON) and to provide guidance for early diagnosis of DON accordingly.

METHODS: A total of 67 eyes of 35 patients with thyroid-associated ophthalmopathy (TAO) were included in this study. Patients were divided into 2 groups (DON group and non-DON group). Parameters were measured on high resolution CT, including muscle index (MI), superior ophthalmic vein (SOV) dilatation, extraocular muscle volume/orbit volume (MV/OV), and intracranial fat prolapsed, and be compared between these 2 groups. The relation between those parameters and visual function [visual acuity (VA) and visual field defect (VF defect)] were also evaluated.

RESULTS: MI and MV/OV were significantly higher in DON group ( P =0.00035 and P =0.00026). No significant difference was detected regarding intracranial fat prolapse existence and SOV dilatation ( P =0.37 and P =0.15). MV/OV was found to have significant negative correlation with both VF defect ( R =-0.332, P =0.0273) and VA ( R =-0.635, P =0.00) while MI was found to have negative linear correlation with VA only ( R =-0.456, P =0.00017). The area under receiver operating characteristic curves was 0.82 for MV/OV and 0.75 for MI. The best performance in detecting DON was achieved when MV/OV is set at 0.20 with 72% sensitivity and 87% specificity and MI is set at 0.52 with 64% sensitivity and 80% specificity.

CONCLUSION: MI and MV/OV are predictive parameters for DON. Together with clinical manifestations, MV/OV≥0.2 can be used as a good indicator for DON in TAO patients.

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