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Central and peripheral contrast sensitivity in thyroid eye disease.

Kasturi Bhattacharjee1, Obaidur Rehman2, Parul Ichhpujani3

  • 1Department of Ophthalmic Plastic and Reconstructive Surgery and Oculofacial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, Assam, India.

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Contrast sensitivity (CS) testing reveals visual function compromise in thyroid eye disease (TED) even with normal visual acuity. Peripheral CS worsens with inflammation and dysthyroid optic neuropathy (DON), aiding early DON diagnosis.

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Area of Science:

  • Ophthalmology
  • Neuro-ophthalmology
  • Medical Imaging

Background:

  • Thyroid eye disease (TED) can impact visual function, sometimes subtly.
  • Dysthyroid optic neuropathy (DON) is a sight-threatening complication of TED.
  • Assessing visual function beyond standard visual acuity is crucial for early detection of TED complications.

Purpose of the Study:

  • To evaluate central and peripheral contrast sensitivity (CS) in patients with thyroid eye disease (TED).
  • To compare CS in TED patients with and without dysthyroid optic neuropathy (DON).
  • To determine the relationship between disease activity and CS in TED.

Main Methods:

  • Cross-sectional study comparing 18 TED patients (33 eyes) with 18 healthy controls.
  • Ophthalmic examination including visual acuity, intraocular pressure, and slit-lamp biomicroscopy.
  • Central and peripheral contrast sensitivity (CS) assessed using the Spaeth-Richman Contrast Sensitivity test.

Main Results:

  • TED patients showed significantly reduced central and total CS compared to controls (P < 0.001).
  • Significant CS deficits were observed in central and peripheral areas in DON eyes versus non-DON eyes (P < 0.05).
  • Increasing clinical activity score correlated with reduced peripheral CS in three of four regions (P < 0.05).

Conclusions:

  • Contrast sensitivity testing detects visual impairment in TED, even with normal visual acuity.
  • Peripheral CS impairment is linked to increased inflammation and DON.
  • Serial CS monitoring may facilitate early diagnosis of DON.