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Chromatic visual evoked potentials identify optic nerve dysfunction in patients with Graves’ orbitopathy

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Abstract

Purpose

To explore visual dysfunction in Graves’ orbitopathy (GO) objectively by analyzing chromatic visual evoked potentials (cVEP) and evaluate its diagnostic efficiency for dysthyroid optic neuropathy (DON).

Methods

In this cross-sectional study, we analyzed pattern-reversal VEP (pVEP), red–green (R–G) and blue–yellow (B–Y) cVEP in 93 subjects (21 with DON, Group A, 30 with GO, Group B, and 42 healthy controls, Group C) at Wuhan Union Hospital, China.

Results

Compared with Group C, the amplitudes of B-Y cVEP were significantly lower in Group B, whereas all amplitudes of cVEP, latencies and amplitudes of pVEP in Group A were significantly impaired. In addition, the pVEP latency at 60 arcmin (60'), pVEP amplitudes and R–G cVEP amplitudes were significantly different between Group A and B. Moreover, 60’cVEP R–G negative–positive (N–P) amplitude was correlated with crowding index (P = 0.001), the average thickness of ganglion cell layer and inner plexiform layer (P = 0.004). Furthermore, combination of 60’cVEP R–G amplitude and 60’pVEP P100 latency had better diagnostic efficiency than each single parameter, with optimal cut-off values of 14.20 μV and 110.65 ms, respectively.

Conclusion

GO may induce electrophysiological changes. The presence of B–Y cVEP anomalies in moderate to severe GO patients may be an early sign of preclinical DON. A decline in 60’cVEP R–G amplitude is associated with apical crowding and thinner inner intra-retinal layers. The combination of 60’cVEP R–G N–P amplitude and 60’pVEP latency can be a useful diagnostic index for DON.

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Data availability

The datasets used in the current study are available from the corresponding authors on reasonable request.

Code availability

Not applicable.

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Acknowledgements

We thank Prof. Feng Gao (Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China), for the guidance in the diagnosis of the patients’ thyroid diseases.

Funding

This work was supported by the National Science Foundation of China (No. 81900912).

Author information

Author notes

  1. Yueqi Yu and Bingjie Shi contributed equally to the work presented here and should therefore be regarded as equivalent authors.

Authors and Affiliations

  1. Department of Ophthalmology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China

    Yueqi Yu

  2. Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China

    Yueqi Yu

  3. Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Yueqi Yu, Bingjie Shi, Shengnan Cheng, Yushuai Liu, Ru Zhu, Yayan You, Jin Chen, Xiaohuan Pi, Xinghua Wang & Fagang Jiang

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Contributions

Design of the study (YQ Y, B S, X W, F J); data collection (YQ Y, B S, S C, Y L, R Z, YY Y, J C, X P, X W); statistical analysis (YQ Y, B S); drafting of the manuscript (YQ Y, B S, X W, F J); funding acquisition (X W); supervision (X W, F J). All authors read and approved the manuscript to be published.

Corresponding authors

Correspondence to Xinghua Wang or Fagang Jiang.

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Conflict of interest

The authors have no conflict of interest to declare that are relevant to content to this article.

Ethical approval

The present study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Research Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (approving number: 2021–0246).

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We have obtained consent to publish from the patients to report the data.

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Yu, Y., Shi, B., Cheng, S. et al. Chromatic visual evoked potentials identify optic nerve dysfunction in patients with Graves’ orbitopathy. Int Ophthalmol 42, 3713–3724 (2022). https://doi.org/10.1007/s10792-022-02369-4

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  • DOI: https://doi.org/10.1007/s10792-022-02369-4

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