Evaluation of visual evoked potentials in dysthyroid optic neuropathy

ABSTRACT

Purpose

To evaluate the findings of visual evoked potentials (VEP) in patients with dysthyroid optic neuropathy (DON).

Methods

In this observational, cross-sectional study 40 eyes (22 patients) with a diagnosis of DON were included.

Results

We discovered that in 16 out of 37 eyes with pattern-VEP (p-VEP), the latency of P100 wave was normal in spite of having a diagnosis of DON. The same pattern was also observed in the measurement of the amplitude of P100 wave: in 28 out of 37 eyes with p-VEP the amplitudes were observed as normal. In 3 eyes of 3 patients p-VEP showed no response, therefore a flash-VEP (f-VEP) was performed. Flash-VEPs of those patients indicated a prolonged P100 latency with a reduced amplitude. The sensitivity of abnormal P100 latency was 56.8% (95%CI 39.5–72.9%); and that of reduced P100 amplitude was 24.3% (95%CI 11.8–41.2%). Also, in 40 eyes color vision test by Arden was performed. In 36 eyes (20 patients) the tritan value was pathological (based on a threshold of ≥8%).

Conclusion

According our data, VEP seems to have a limited potential especially in patients with a good best-corrected visual acuity (BCVA ≤0.2 LogMAR) for identifying the optic nerve involvement. The fact that P100 latency and amplitude were normal even in cases with an optic nerve swelling makes us question the usefulness of the VEP for diagnosing cases of DON in daily clinical life.

KEYWORDS:

• Compressive optic neuropathy
• dysthyroid optic neuropathy
• thyroid eye disease
• visual evoked potentials

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.