title: Clinical features of dysthyroid optic neuropathy: a European Group on Graves' Orbitopathy (EUGOGO) survey.
abstract: BACKGROUND
  This study was performed to determine clinical features of dysthyroid optic neuropathy (DON) across Europe.
  
  
  METHODS
  Forty seven patients with DON presented to seven European centres during one year. Local protocols for thyroid status, ophthalmic examination and further investigation were used. Each eye was classified as having definite, equivocal, or no DON.
  
  
  RESULTS
  Graves' hyperthyroidism occurred in the majority; 20% had received radioiodine. Of 94 eyes, 55 had definite and 17 equivocal DON. Median Clinical Activity Score was 4/7 but 25% scored 3 or less, indicating severe inflammation was not essential. Best corrected visual acuity was 6/9 (Snellen) or worse in 75% of DON eyes. Colour vision was reduced in 33 eyes, of which all but one had DON. Half of the DON eyes had normal optic disc appearance. In DON eyes proptosis was > 21 mm (significant) in 66% and visual fields abnormal in 71%. Orbital imaging showed apical muscle crowding in 88% of DON patients. Optic nerve stretch and fat prolapse were infrequently reported.
  
  
  CONCLUSIONS
  Patients with DON may not have severe proptosis and orbital inflammation. Optic disc swelling, impaired colour vision and radiological evidence of apical optic nerve compression are the most useful clinical features in this series.
authors.affiliation: Centre for Endocrine and Diabetes Sciences, University Hospital of Wales, Cardiff CF 4 4XN, UK.
authors.forename: David
authors.initials: D
authors.lastname: McKeag
authors.forename: Carol
authors.initials: C
authors.lastname: Lane
authors.forename: John H
authors.initials: JH
authors.lastname: Lazarus
authors.forename: Lelio
authors.initials: L
authors.lastname: Baldeschi
authors.forename: Kostas
authors.initials: K
authors.lastname: Boboridis
authors.forename: A Jane
authors.initials: AJ
authors.lastname: Dickinson
authors.forename: A Iain
authors.initials: AI
authors.lastname: Hullo
authors.forename: George
authors.initials: G
authors.lastname: Kahaly
authors.forename: Gerry
authors.initials: G
authors.lastname: Krassas
authors.forename: Claudio
authors.initials: C
authors.lastname: Marcocci
authors.forename: Michele
authors.initials: M
authors.lastname: Marinò
authors.forename: Maarten P
authors.initials: MP
authors.lastname: Mourits
authors.forename: Marco
authors.initials: M
authors.lastname: Nardi
authors.forename: Christopher
authors.initials: C
authors.lastname: Neoh
authors.forename: Jacques
authors.initials: J
authors.lastname: Orgiazzi
authors.forename: Petros
authors.initials: P
authors.lastname: Perros
authors.forename: Aldo
authors.initials: A
authors.lastname: Pinchera
authors.forename: Susanne
authors.initials: S
authors.lastname: Pitz
authors.forename: Mark F
authors.initials: MF
authors.lastname: Prummel
authors.forename: Maria S
authors.initials: MS
authors.lastname: Sartini
authors.forename: Wilmar M
authors.initials: WM
authors.lastname: Wiersinga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003117:Color Vision Defects / Q000209:etiology; D003941:Diagnostic Techniques, Ophthalmological; D004172:Diplopia / Q000209:etiology; D005260:Female; D049970:Graves Ophthalmopathy / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D012720:Severity of Illness Index; D014792:Visual Acuity