Abstract
Purpose. To compare the contrast sensitivity levels of thyroid associated ophthalmopathy (TAO) patients without obvious optic neuropathy with those of healthy people. Methods. Forty eyes of 20 TAO patients without dysthyroid optic neuropathy and 40 eyes of 20 healthy subjects were evaluated in this prospective case-controlled study. The contrast sensitivity functions (CSFs) of all subjects were measured by the functional acuity contrast test (FACT) in five frequencies which were 1,5 cpd (A), 3 cpd (B), 6 cpd (C), 12 cpd (D), and 18 cpd (E). Results were compared for both groups, and a correlation of CSF with Hertel and clinical activity scores was assessed. Results. There was no statistically significant difference between TAO patients and control groups for age and sex. TAO patients had lower levels than the control group in all the frequencies of CSFs (P < 0.05) and the difference in contrast sensitivity functions between the groups seems to be more significant in higher frequencies (B, C, D, and E) (P < 0.001). Conclusions. TAO patients without DON can have contrast sensitivity loss and this would probably imply subtle optic nerve dysfunction in early disease phase.
Highlights
Thyroid associated ophthalmopathy (TAO) is related to autoimmune inflammation of orbital tissues [1]
contrast sensitivity functions (CSFs) test is noninvasive and sensitive test for the determination of early effects of glaucoma [6], multiple sclerosis [7, 8], optic neuropathies, and compressive lesions of anterior visual pathway [9, 10] and it enables detecting the central deficits of visual field that may be missed by Snellen vision test [18]
We evaluated the function of optic nerve by contrast sensitivity function test and we found that it is decreased in all TAO patients
Summary
Thyroid associated ophthalmopathy (TAO) is related to autoimmune inflammation of orbital tissues [1]. Thereby, the stress over the optic nerve must be evaluated by the qualitative methods and the decision of treatment should be supported by objective criteria. Determination of visual acuity level is the most common and easy way for the evaluation of visual system, visual acuity may not be affected in some TAO patients with optic nerve under stress [3, 5]. Contrast sensitivity function (CSF) has been shown to be sensitive for the detection of visual disturbance in many ophthalmic disorders before the impairment of visual acuity and it is widely used in diagnosing and following these diseases, such as glaucoma [6], multiple sclerosis [7, 8], optic neuropathies [9, 10], and Grave’s ophthalmopathy [11]. We need a threshold for therapeutic intervention, we think that functional disturbance in optic nerve probably starts with early stages of TAO
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