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Thyroid-associated ophthalmopathy: Using diffusion tensor imaging to evaluate visual pathway microstructural changes.

Rui Li1, Jing Li1, Zhenchang Wang1

  • 1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Frontiers in Neurology
|November 21, 2022
PubMed
Summary

Thyroid-associated ophthalmopathy (TAO) alters visual pathway diffusion tensor imaging (DTI) parameters in moderate-severe patients. Fractional anisotropy (FA) of the lateral geniculate (LG) and optic radiation (OR) show significant changes, indicating subclinical damage.

Keywords:
arterial spin labelingdiffusion tensor imaginglateral geniculateoptic radiationthyroid associated ophthalmopathy

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Area of Science:

  • Ophthalmology
  • Neurology
  • Radiology

Background:

  • Thyroid-associated ophthalmopathy (TAO) is an autoimmune condition affecting the eye muscles and orbital tissues.
  • Dysthyroid optic neuropathy (DON) is a severe complication of TAO, leading to vision loss.
  • Early detection of visual pathway involvement in TAO is crucial for timely intervention.

Purpose of the Study:

  • To investigate subclinical changes in the visual pathway of TAO patients using diffusion tensor imaging (DTI).
  • To determine if DTI parameters can predict the development of dysthyroid optic neuropathy (DON).

Main Methods:

  • Diffusion tensor imaging (DTI) was used to measure fractional anisotropy (FA) and mean diffusivity (MD) in the lateral geniculate (LG) and optic radiation (OR).
  • Fifty-seven TAO patients and 30 healthy controls (HCs) were included.
  • Ophthalmic examinations and clinical activity scores (CAS) were assessed.

Main Results:

  • Moderate-to-severe TAO patients exhibited significantly lower FA and higher MD in the LG and OR compared to HCs.
  • FA of the optic radiation (OR) correlated negatively with CAS and intraocular pressure.
  • FA of the lateral geniculate (LG) and OR were significant predictors for TAO diagnosis.

Conclusions:

  • DTI reveals significant alterations in the visual pathway of moderate-to-severe TAO patients.
  • FA of the lateral geniculate (LG) serves as a sensitive imaging biomarker for subclinical visual pathway damage in TAO.