title: Clinical profile and visual outcomes after treatment in patients with dysthyroid optic neuropathy.
abstract: OBJECTIVE
  To report the clinical data and visual outcomes after treatment of patients with dysthyroid optic neuropathy (DON).
  
  
  METHODS
  We retrospectively reviewed the medical records and orbital images of 40 patients (65 eyes) with DON and analyzed the visual outcomes after treatment with intravenous steroids pulse therapy, radiotherapy and orbital decompression.
  
  
  RESULTS
  The study included 21 men and 19 women, with 10 (25%) being diabetic patients. Visual field test results revealed defects in 88.7% of DON eyes; afferent pupillary defects in 63.2%; reduced color vision in 78.5%; and abnormal visual evoked potentials in 84%. Orbital imaging showed moderate to severe apical crowding in 95% of the orbits and intracranial fat prolapse in 24.2%. Median best corrected visual acuity improved from 0.4 to 1.0 after one year of treatment (p < 0.001). We noted more improvement in vision with the use of decompressive surgery than with non-surgical methods (p < 0.05). Recurrences occurred in 7 patients who had not received orbital radiotherapy.
  
  
  CONCLUSIONS
  Visual field defects and apical crowding seen on orbital imaging were the most sensitive indicators for the detection of DON. Treatment with intravenous steroids pulse therapy, radiotherapy and orbital decompression effectively improved visual outcomes in cases of DON.
authors.affiliation: Seoul Eye Clinic, Hampyeong, Korea.
authors.forename: Chan
authors.initials: C
authors.lastname: Jeon
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Shin
authors.forename: Kyung In
authors.initials: KI
authors.lastname: Woo
authors.forename: Yoon-Duck
authors.initials: YD
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D048909:Diabetes Complications; D005074:Evoked Potentials, Visual; D005260:Female; D049970:Graves Ophthalmopathy / Q000473:pathology / Q000601:surgery / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020551:Pulse Therapy, Drug; D011681:Pupil Disorders; D011878:Radiotherapy; D020127:Recovery of Function; D012189:Retrospective Studies; D055502:Secondary Prevention; D013256:Steroids / Q000008:administration & dosage*; D014792:Visual Acuity; D014794:Visual Fields; D055815:Young Adult
chemical_list: D013256:Steroids