Investigating the Correlation Between Choroidal Alteration and Visual Function Metrics in Dysthyroid Optic Neuropathy

Area of Science:

• Ophthalmology
• Neuro-ophthalmology
• Medical Imaging

Background:

• Dysthyroid optic neuropathy (DON) is a sight-threatening complication of thyroid eye disease (TED).
• Assessing visual function and disease activity in DON is crucial for timely intervention.
• Current diagnostic methods may not fully capture the subtle structural changes impacting vision.

Purpose of the Study:

• To investigate the relationship between choroidal and optic disc structural changes and visual function metrics in patients with DON.
• To identify potential imaging biomarkers for disease activity and visual impairment in DON.

Main Methods:

• Retrospective cross-sectional study of 38 TED patients.
• Wide-field optical coherence tomography angiography (OCTA) for 3D choroidal and optic disc analysis (thickness, vascularity).
• Visual function assessed via visual acuity, pattern visual evoked potential (P-VEP), and automated perimetry (mean sensitivity).

Main Results:

• Visual acuity and mean sensitivity decreased with increasing TED severity.
• DON patients exhibited lower P-VEP amplitude.
• Significant correlations found between optic disc choroidal vascularity index, nasal superior choroidal metrics, and RNFL blood flow density with visual function (mean sensitivity and P-VEP amplitude).

Conclusions:

• Choroidal alterations are strongly associated with visual function deficits in DON.
• Choroidal thickness and vascularity metrics derived from OCTA may serve as valuable biomarkers for DON.
• These biomarkers can aid in assessing disease activity and visual impairment, guiding clinical management.