Optic neuropathy associated with thyroid-related auto-antibodies

Abstract

The authors observed five females having severe visual loss without ocular features of dysthyroid orbitopathy, but in whom thyroid-related autoantibodies were identified. Humphrey field analysis appeared to be characterized by a peripheral field loss. Visual functions recovered, at least in part, in all patients after pulse treatments of methylprednisolone. High titers of antinuclear antibody and thyroid-related autoantibodies (anti-thyroid peroxidase and anti-thyroglobulin) were found and these levels decreased after treatment. Recurrence of visual loss occurred following the tapering of the corticosteroid. Multiple sclerosis was not suspected in the neurological findings nor the MRI during the clinical course of each patient. We believe the present cases can be regarded as a subclass of autoimmune optic neuropathy. Attention should be directed toward thyroid-related autoantibodies in optic neuropathy when physicians are faced with similar cases of non-demyelinating optic neuropathy.