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Optic nerve sheath infiltration in dysthyroid optic neuropathy
Khizar Rana1,2, Reema Madike3,4, James Leyden3,4
1Department of Ophthalmology & Visual Sciences, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia. khizar.rana@adelaide.edu.au.
Eye (London, England)
|November 27, 2023
Summary
Optic nerve sheath infiltration may predict dysthyroid optic neuropathy. Fat infiltration and scleral enhancement can help detect active thyroid eye disease, aiding diagnosis and patient stratification.
Area of Science:
- Ophthalmology
- Radiology
- Endocrinology
Background:
- Thyroid eye disease (TED) is an autoimmune condition affecting the orbits.
- Dysthyroid optic neuropathy (DON) is a vision-threatening complication of TED.
- Accurate diagnosis and stratification of TED activity and DON are crucial for effective management.
Purpose of the Study:
- To evaluate the association between specific MRI findings and active TED.
- To determine if these findings correlate with the presence of dysthyroid optic neuropathy.
- To explore the utility of radiological markers in assessing TED.
Main Methods:
- Retrospective analysis of MRI scans from 38 TED patients (76 orbits).
- Assessment of optic nerve sheath (ONS) infiltration, intraorbital fat infiltration, and scleral enhancement.
- Correlation of imaging findings with clinical assessments of disease activity and DON by orbital surgeons/neuro-ophthalmologists.
Main Results:
- ONS infiltration, fat infiltration, and scleral enhancement were all significantly associated with active TED.
- ONS infiltration showed a significant association with dysthyroid optic neuropathy (OR 3.4, p<0.05).
- Fat infiltration and scleral enhancement were not significantly associated with DON in this cohort.
Conclusions:
- Optic nerve sheath infiltration may serve as a predictor for dysthyroid optic neuropathy.
- Intraorbital fat infiltration and scleral enhancement are potential imaging biomarkers for active TED.
- These radiological findings can aid in the diagnosis and stratification of TED patients.
