Abstract
This study aimed to characterize the changes in the visual field (VF) patterns and disc morphology of patients with thyroid-associated orbitopathy (TAO) and open-angle glaucoma (OAG). A retrospective review of the medical records at the Tri-Service General Hospital in Taiwan identified 396 eyes of 198 patients with thyroid-associated glaucoma. A final follow-up of VF examination in 140 eyes revealed 114 eyes with VF defects, indicating disease progression. The characteristics of and changes in disc morphology, optical coherence tomography findings, and VF defects were statistically analyzed. The most common VF defects at the initial diagnosis and the end of the follow-up period were inferior partial arcuate (17%) and paracentral (15%) defects, respectively. The most common VF defect in patients with unspecific disc signs was an unspecific scotoma (13%). The most common optic disc feature was disc cupping (51%), followed by parapapillary atrophy (48%). The most frequent location of nerve fiber layer thinning was the inferotemporal region (48%). VF defects showed a significantly more pronounced progression in the non-nerve fiber bundle group than in the nerve fiber bundle group (p < 0.001). This study details the characteristics and progression of disc morphology and VF defects in patients with TAO and OAG.
Highlights
Graves’ ophthalmopathy, known as thyroid-associated orbitopathy (TAO) or thyroid eye disease, is an autoimmune inflammatory disease usually observed in dysthyroid patients [1]
In patients with TAO complicated by glaucomatous signs, it is difficult for clinicians to clearly differentiate between glaucomatous optic neuropathy and compressive optic neuropathy (CON)
This study focused on disc morphology and visual field (VF) defects in patients with TAO and open-angle glaucoma and found that annual mean deviation (MD) changes were significantly different between patients with nonnerve fiber bundle VF defects and those with nerve fiber bundle VF defects according to the VF defect patterns
Summary
Graves’ ophthalmopathy, known as thyroid-associated orbitopathy (TAO) or thyroid eye disease, is an autoimmune inflammatory disease usually observed in dysthyroid patients [1]. Hyperthyroidism comprises the majority of TAO disease cases, with only a minority presenting a euthyroid or hypothyroid status. The incidence rate of TAO peaks between 30 and 50 years of age, with a sex distribution of sixteen women and three men per 100,000 population [1]. TAO pathogenesis is postulated as a series of effects caused by activating autoantibodies against the thyrotropin receptor and the insulin-like growth factor 1 receptor [2,3]. The symptoms comprise eyelid lag, eyelid retraction, proptosis, extraocular muscle dysfunction, Licensee MDPI, Basel, Switzerland
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