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Predictive parameters on CT scan for dysthyroid optic neuropathy.

Bo Yu1, Can Gong2, Yuan-Fei Ji3

  • 1Department of Orbital and Oculoplastic Surgery, Eye Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.

International Journal of Ophthalmology
|August 22, 2020
PubMed
Summary

CT scan parameters like muscle index and extraocular muscle volume to orbit volume ratio can help predict dysthyroid optic neuropathy (DON). A ratio of 0.2 or higher for MV/OV is a good indicator for early DON diagnosis in thyroid-associated ophthalmopathy patients.

Keywords:
dysthyroid optic neuropathyintracranial fat prolapsemuscle indexmuscle volume/orbital volumesuperior ophthalmic vein dilatation

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Area of Science:

  • Ophthalmology
  • Radiology
  • Endocrinology

Background:

  • Thyroid-associated ophthalmopathy (TAO) can lead to dysthyroid optic neuropathy (DON), potentially causing vision loss.
  • Early diagnosis of DON is crucial for timely intervention and preserving visual function.

Purpose of the Study:

  • To evaluate the predictive value of specific CT scan parameters for diagnosing DON.
  • To establish CT-based criteria for the early detection of DON in TAO patients.

Main Methods:

  • High-resolution CT scans were analyzed in 67 eyes of 35 TAO patients, divided into DON and non-DON groups.
  • Measured parameters included muscle index (MI), superior ophthalmic vein (SOV) dilatation, extraocular muscle volume/orbit volume (MV/OV), and intracranial fat prolapse.
  • Correlation between CT parameters and visual function (visual acuity and visual field defect) was assessed.

Main Results:

  • Muscle index (MI) and MV/OV were significantly higher in the DON group (P=0.00035 and P=0.00026, respectively).
  • MV/OV showed a significant negative correlation with visual field defects and visual acuity.
  • MI demonstrated a negative linear correlation with visual acuity. MV/OV (0.82) and MI (0.75) showed good diagnostic performance via ROC analysis.

Conclusions:

  • MI and MV/OV are valuable CT parameters for predicting DON.
  • An MV/OV ratio of ≥0.2, combined with clinical findings, serves as a reliable indicator for DON in TAO patients.