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Utility of isolated-check visual evoked potential technique in dysthyroid optic neuropathy

医学 眼科 接收机工作特性 视力 乳头水肿 眼压 视神经病变 视神经 内科学
作者
Ban Luo,Rong Liu,Shanluxi Wang,Weikun Hu,Yun Li,Boding Tong,Hong Zhang,Xin Qi
出处
期刊:Graefes Archive for Clinical and Experimental Ophthalmology [Springer Science+Business Media]
卷期号:261 (7): 2031-2040 被引量:3
标识
DOI:10.1007/s00417-023-05975-9
摘要

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.
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