Greater Proptosis Is Not Associated With Improved Compressive Optic Neuropathy in Thyroid Eye Disease

Ophthalmic Plastic and Reconstructive Surgery
Tavish NandaMichael Kazim

Abstract

Despite the paucity of supporting data, it has generally been held that proptosis in thyroid eye disease (TED) may provide relative protection from compressive optic neuropathy (CON) by producing spontaneous decompression. The objective of this study was to investigate this phenomenon in patients with bilateral TED-CON. We retrospectively reviewed the charts of 67 patients (134 orbits) with bilateral TED-CON at Columbia-Presbyterian Medical Center. Significant asymmetric proptosis (Hertel) was defined as ≥ 2 mm. Significant asymmetric CON was defined first, as the presence of an relative afferent pupillary defect. Those without an relative afferent pupillary defect were evaluated according to the TED-CON formula y = -0.69 - 0.31 × (motility) - 0.2 × (mean deviation) - 0.02 × (color vision) as previously established for the diagnosis of TED-CON. A difference in the formula result ≥ 1.0 between eyes was considered significant. Patients were then divided into 4 groups. Forty-one of 67 patients demonstrated asymmetric CON (29 by relative afferent pupillary defect, 12 by formula). Twenty-one of 67 patients demonstrated asymmetric proptosis. Only 5 of 12 (41.6%) of the patients who had both asymmetric proptosis and asymmetric CON (gr...Continue Reading

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Citations

Nov 20, 2019·Ophthalmic Plastic and Reconstructive Surgery·Geoffrey E Rose, Kaveh Vahdani
Dec 4, 2019·Ophthalmic Plastic and Reconstructive Surgery·Brendon W H LeeIan C Francis
Jan 22, 2021·World Neurosurgery·Sebastian KuechlinJuergen Grauvogel
Oct 14, 2021·European Radiology·Mengsha ZouZhiyun Yang

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