Thyroid Eye Disease-Compressive Optic Neuropathy

Abstract

The aim of this study was to evaluate the functional outcomes in terms of best-corrected visual acuity (BCVA) and visual field (VF) defects in optic nerve compression (thyroid eye disease-compressive optic neuropathy, TED-CON) patients after treatment. In this observational, retrospective study, the medical charts of 51patients (96eyes) with adiagnosis of definitive TED-CON between 2010-2020 were included. After the diagnosis of TED-CON, 16patients (27eyes) received steroid-pulse (medical) treatment alone, 67eyes received an additional surgical orbital decompression, whereas 1 patient (2 eyes) refused both treatment methods. In 74eyes (77.1%) we detected an improvement of the BCVA ≥ 2 lines after the treatment over amean time interval of 31.7weeks (with no significant difference between treatment methods). In 22eyes (27.2%) out of the81 that underwent aposttreatment VF examination, we observed acomplete resolution of the defects over amean time interval of 39.9weeks. When we limited analysis to patients with aminimum follow-up of 6months at last visit, we found 33eyes (61.1%) out of 54eyes still had aVF defect. In our data, more than half of the TED-CON cases (61.5%) had a good prognosis with afinal BCVA ≥ 0.8 at the last visit; however, only 22eyes (27.2%) showed acomplete resolution of VF defects, while 33eyes (61.1%) had residual defects measured after aminimum follow-up of 6months. These results suggest that while the BCVA recovers relatively well, the VF of patients is likely to remain marked by optic nerve compression.