Diagnostic methods for dysthyroid optic neuropathy: A systematic review and analysis

Area of Science:

• Ophthalmology
• Neurology

Background:

• Dysthyroid optic neuropathy (DON) diagnosis traditionally relies on clinical features.
• Ancillary tests like visual field (VF), pattern visual evoked potential (pVEP), and neuroimaging are often used.
• Current diagnostic methods for DON lack standardization in published literature.

Purpose of the Study:

• To review and summarize diagnostic methods for dysthyroid optic neuropathy (DON).
• To evaluate the combination of clinical features and ancillary tests in DON diagnosis.
• To highlight the importance of comprehensive diagnostic approaches for DON.

Main Methods:

• Systematic review of 95 studies involving 4619 DON eyes.
• Analysis of diagnostic criteria used in published DON research.
• Assessment of the utilization of clinical features, VF, pVEP, and neuroimaging.

Main Results:

• All studies considered clinical features, with most combining them with ancillary tests.
• Over 42% of studies used at least two ancillary tests (VF, pVEP, neuroimaging).
• Diagnostic methods were unspecified in 64% of published DON studies.

Conclusions:

• Diagnosing DON effectively requires integrating clinical findings with multiple ancillary tests.
• Relying solely on clinical presentation can lead to misdiagnosis.
• Using at least two ancillary tests alongside clinical assessment is crucial for accurate DON diagnosis.