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Francisco J. Munoz Negrete, Marta Pérez-López, Gema Rebolleda, Marco Sales-Sanz, Pilar Casas de Llera; Predictive Value Of Retinal Nerve Fiber Layer Thickness Measured By Optical Coherence Tomography On Visual Recovery In Dysthiroid Optic Neuropathy After Decompression Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2096.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether in vivo retinal nerve fibre layer (RNFL) thickness measurements predict visual recovery after orbital bone decompression surgery in patients with dysthiroid optic neuropathy (DON) and visual field defects.
28 eyes of 15 patients undergoing orbital bone decompression surgery for Graves' orbitopathy were prospectively assessed before orbital decompression and one month after surgery with a neuro-ophthalmic examination, involving standard automated visual field (VF) testing and by spectral domain optical coherence tomography (OCT) measurements of RNFL thickness (Cirrus OCT).
Only in 5 eyes (17,5%) DON was diagnosed. All of them had preoperative VF defects (median mean deviation -MD- was -8,00 dB and median pattern standard deviation -PSD- was 6,06 dB). In 4 eyes preoperative RNFL average thickness was normal and in 1 eye RNFL average thickness was significantly thinned. After decompression surgery, eyes with preoperative normal RNFL thickness showed improvement in MD (-10,05 dB and -4,90 dB before and after surgery respectively p=0,068) and in PSD (5,65 dB before surgery and 2,56 dB after surgery p=0,06) unlike the only eye with abnormally thin preoperative RNFL thickness, which had no improvement in visual field index.
Normal baseline RNFL thickness measured with OCT in eyes with dysthiroid optic neuropathy despite VF defects may predict an improvement in visual outcome after treatment.
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