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A diagnostic model based on color vision examination for dysthyroid optic neuropathy using Hardy-Rand-Rittler color plates

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Abstract

Purpose

To investigate color vision deficiency and the value of Hardy-Rand-Rittler (HRR) color plates in monitoring dysthyroid optic neuropathy (DON) to improve the diagnosis of DON.

Methods

The participants were divided into DON and non-DON (mild and moderate-to-severe) groups. All the subjects underwent HRR color examination and comprehensive ophthalmic examinations. The random forest and decision tree models based on the HRR score were constructed by R software. The ROC curve and accuracy of different models in diagnosing DON were calculated and compared.

Results

Thirty DON patients (57 eyes) and sixty non-DON patients (120 eyes) were enrolled. The HRR score was lower in DON patients than in non-DON patients (12.1 ± 6.2 versus 18.7 ± 1.8, p < 0.001). The major color deficiency was red-green deficiency in DON using HRR test. The HRR score, CAS, RNFL, and AP100 were found to be important factors in predicting DON from random forest and selected by decision tree to construct the multifactor model. The sensitivity, specificity, and the area under the curve (AUC) of the HRR score were 86%, 72%, and 0.87, respectively. The HRR score decision tree had a sensitivity, specificity, and AUC of 93%, 57%, and 0.75, respectively, with an accuracy of 82%. The data of the multifactor decision tree were 90%, 89%, and 0.93 for sensitivity, specificity, and AUC, respectively, with an accuracy of 91%.

Conclusion

The HRR test was valid as screening method for DON. The multifactor decision tree based on the HRR test improved the diagnostic efficacy for DON. An HRR score of less than 12 and red-green deficiency may be characteristic of DON.

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Acknowledgements

Support from numerous colleagues, friends, and experts from Sun Yat-sen Memorial Hospital of Sun Yat-sen University is gratefully acknowledged. The article is dedicated to the members of our research group who have helped a lot.

Funding

This study was supported by research grants from the Science and Technology Bureau of Guangzhou (grant numbers 2021–02-01–04-0203) and the Sun Yat-Sen Clinical Research Cultivating Program.

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    1. Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People’s Republic of China

      Jiaqi Liang, Jing Wang, Shuxian Fan, Xiaowen Deng, Jiafeng Zhang, Jia Zhang, Mei Wang & Peng Zeng

    2. Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, 510000, People’s Republic of China

      Peng Tian

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    Liang, J., Tian, P., Wang, J. et al. A diagnostic model based on color vision examination for dysthyroid optic neuropathy using Hardy-Rand-Rittler color plates. Graefes Arch Clin Exp Ophthalmol 261, 2669–2678 (2023). https://doi.org/10.1007/s00417-023-06062-9

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