Utility of isolated-check visual evoked potential technique in dysthyroid optic neuropathy.
Luo Ban, Liu Rong, Wang Shanluxi, Hu Weikun, Li Yunping, Tong Boding, Zhang Hong, Qi Xin
AI Summary
icVEP effectively distinguished dysthyroid optic neuropathy (DON) from other thyroid eye disease, with reduced signal-to-noise ratio indicating DON. This offers a valuable diagnostic tool for early DON detection.
Abstract
Purpose
To analyze the utility of isolated-check visual evoked potential (icVEP) for discriminating between eyes with dysthyroid optic neuropathy (DON) and eyes with thyroid-associated ophthalmopathy (TAO) but not DON.
Methods
Forty-three eyes with TAO but not DON (as non-DON), fifty-three eyes with DON, and sixty healthy eyes (as controls) were included. Comprehensive ophthalmic examinations, including best-corrected visual acuity, refraction, color vision test, intraocular pressure measurement, slit-lamp biomicroscopy, ophthalmoscopy, RAPD, exophthalmometry measurements, pVEP test, icVEP test, standard automated perimetry, and clinical activity score classification of TAO, as well as demographic information, were collected and analyzed.
Results
In the DON group, the signal-to-noise ratio (SNR) value of icVEPs decreased significantly compared with that of the non-DON group as well as control (p < 0.05). The SNR values under 8%, 16% and 32% depth of modulation (DOM) were significantly negatively correlated with BCVA (p < 0.05, r = - 0.9 ~ - 0.6), papilledema (Y/N) (p < 0.05, r = - 0.8 ~ 0.4) and DON (Y/N) (p < 0.001, r = - 0.7 ~ - 0.5). The 8% DOM of icVEP had the largest area under the receiver operating characteristic curve (AUC) (0.842) for discriminating DON from non-DONs. Meanwhile, decision curve analysis (DCA) showed that patients clinically benefit most from 8% DOM of icVEP. Furthermore, the 8% DOM of icVEP combing with papilledema (Y/N) and BCVA (Model 1) has significantly larger AUC than the 8% DOM of icVEP (p = 0.0364), and has better clinical benefit in DCA analysis.
Conclusions
The SNR of 8% DOM from icVEP may represent a significant ancillary diagnostic method for DON detection. Furthermore, icVEP combined with papilledema (Y/N) and BCVA should be considered as a diagnostic model in future clinical practice.
MeSH Terms
Shields Classification
Key Concepts6
In eyes with dysthyroid optic neuropathy (DON), the signal-to-noise ratio (SNR) value of isolated-check visual evoked potentials (icVEPs) decreased significantly compared with eyes with thyroid-associated ophthalmopathy (TAO) but not DON (non-DON group) and healthy control eyes (p < 0.05).
The signal-to-noise ratio (SNR) values of isolated-check visual evoked potentials (icVEPs) under 8%, 16%, and 32% depth of modulation (DOM) were significantly negatively correlated with best-corrected visual acuity (BCVA) (p < 0.05, r = -0.9 to -0.6), papilledema (Y/N) (p < 0.05, r = -0.8 to 0.4), and dysthyroid optic neuropathy (DON) (Y/N) (p < 0.001, r = -0.7 to -0.5) in a cohort of 43 eyes with TAO but not DON, 53 eyes with DON, and 60 healthy eyes.
The 8% depth of modulation (DOM) of isolated-check visual evoked potentials (icVEP) had the largest area under the receiver operating characteristic curve (AUC) (0.842) for discriminating dysthyroid optic neuropathy (DON) from non-DONs in a cohort of 43 eyes with TAO but not DON and 53 eyes with DON.
Decision curve analysis (DCA) showed that patients clinically benefit most from the 8% depth of modulation (DOM) of isolated-check visual evoked potentials (icVEP) for discriminating dysthyroid optic neuropathy (DON) from non-DONs in a cohort of 43 eyes with TAO but not DON and 53 eyes with DON.
The 8% depth of modulation (DOM) of isolated-check visual evoked potentials (icVEP) combined with papilledema (Y/N) and best-corrected visual acuity (BCVA) (Model 1) has a significantly larger area under the receiver operating characteristic curve (AUC) than the 8% DOM of icVEP alone (p = 0.0364) for discriminating dysthyroid optic neuropathy (DON) from non-DONs in a cohort of 43 eyes with TAO but not DON and 53 eyes with DON.
The 8% depth of modulation (DOM) of isolated-check visual evoked potentials (icVEP) combined with papilledema (Y/N) and best-corrected visual acuity (BCVA) (Model 1) has better clinical benefit in decision curve analysis (DCA) for discriminating dysthyroid optic neuropathy (DON) from non-DONs in a cohort of 43 eyes with TAO but not DON and 53 eyes with DON.
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