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Published on: April 14, 2014
Visual neuropraxia and progressive vision loss from thyroid-associated stretch optic neuropathy
Chetan R Soni1, Lenworth N Johnson
1Neuro-Ophthalmology Unit, Mason Eye Institute, University of Missouri-Columbia, Columbia, MO 65212, USA.
European Journal of Ophthalmology
|December 29, 2009
Summary
Stretch optic neuropathy, a cause of vision loss in thyroid eye disease, can cause temporary visual impairment. Prompt orbital decompression may prevent irreversible vision loss.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Limited in vivo data exists on human optic nerve tensile strength.
- Thyroid eye disease can lead to optic nerve compromise.
Observation:
- Three cases of thyroid-associated stretch optic neuropathy were analyzed.
- Patients presented with moderate to severe proptosis and visual disturbances.
- Retinal hemorrhages suggesting venous stasis retinopathy were noted in two patients.
Findings:
- Stretch optic neuropathy initially manifests as neuropraxia with temporary vision loss.
- Orbital decompression improved visual function and resolved venous stasis retinopathy.
- One case indicated a rapid rate of visual field loss, projecting blindness within approximately two years.
Implications:
- Early recognition of stretch optic neuropathy is crucial for vision preservation.
- Surgical intervention, such as orbital decompression, should be considered before irreversible optic nerve damage occurs.
- This condition highlights the importance of managing thyroid eye disease to prevent vision-threatening complications.
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