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Using frequency-doubling perimetry to detect optic neuropathy in patients with Graves’ orbitopathy

Abstract

Purpose

to test the ability of frequency-doubling technology (FDT) perimetry to detect dysthyroid optic neuropathy (DON).

Methods

Fifteen eyes of 15 patients with DON and 15 healthy control eyes were studied. Eligible eyes had a diagnosis of DON based on visual field abnormalities on standard automated perimetry and had visual acuity better than 20/30. FDT testing was performed using both the C-20-5 screening test and the C-20 full-threshold test. Normal and DON eyes were compared with regard to FDT mean sensitivity.

Results

Sensitivity ranges were 40.0%–86.7% for the screening test, and 53.3%–100.0% (total deviation) and 20.0–93.3 (pattern deviation) for the C-20 threshold test. The corresponding specificity ranges were 86.7–100.0, 33.3–93.3, and 26.7–100.0, respectively. The best sensitivity/specificity ratios were for one abnormal point depressed <5% in the screening test (86.7%/86.7%), one point depressed <1% in the total deviation analysis (80.0%/86.7%), and one point depressed <2% in the pattern deviation analysis (80.0%/86.7%). DON eyes presented significantly lower than normal average sensitivity in the central, pericentral, and peripheral areas.

Conclusions

FDT perimetry is a useful screening tool for DON in eyes with normal or only slightly reduced visual acuity.

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References

  1. Neigel JM, Rootman J, Belkin RI, et al. Dysthyroid optic neuropathy. The crowded orbital apex syndrome. Ophthalmology 1988;95:1515–1521.

    CAS  Article  PubMed  Google Scholar 

  2. Kazim M, Trokel S, Moore S. Treatment of acute Graves orbitopathy. Ophthalmology 1991;98:1443–1448.

    CAS  Article  PubMed  Google Scholar 

  3. Anderson D, Patella V. Automated perimetry, 2nd ed. St Louis: Mosby; 1999. p. 1–363.

    Google Scholar 

  4. Katz J, Tielsch JM, Quigley HA, Sommer A. Automated perimetry detects visual field loss before manual Goldmann perimetry. Ophthalmology 1995;102:21–26.

    CAS  Article  PubMed  Google Scholar 

  5. Khoury JM, Donahue SP, Lavin PJ, Tsai JC. Comparison of 24-2 and 30-2 perimetry in glaucomatous and nonglaucomatous optic neuropathies. J Neuroophthalmol 1999;19:100–108.

    CAS  Article  PubMed  Google Scholar 

  6. Wall M. What’s new in perimetry. J Neuroophthalmol 2004;24:46–55.

    Article  PubMed  Google Scholar 

  7. Bengtsson B, Heijl A, Olsson J. Evaluation of a new threshold visual field strategy, SITA, in normal subjects. Swedish Interactive Thresholding Algorithm. Acta Ophthalmol Scand 1998;76:165–169.

    CAS  Article  PubMed  Google Scholar 

  8. Johnson CA, Samuels SJ. Screening for glaucomatous visual field loss with frequency-doubling perimetry. Invest Ophthalmol Vis Sci 1997;38:413–425.

    CAS  PubMed  Google Scholar 

  9. Quigley HA. Identification of glaucoma-related visual field abnormality with the screening protocol of frequency doubling technology. Am J Ophthalmol 1998;125:819–829.

    CAS  Article  PubMed  Google Scholar 

  10. Kelly DH. Nonlinear visual responses to flickering sinusoidal gratings. J Opt Soc Am 1981;71:1051–1055.

    CAS  Article  PubMed  Google Scholar 

  11. Fujimoto N, Adachi-Usami E. Frequency doubling perimetry in resolved optic neuritis. Invest Ophthalmol Vis Sci 2000;41:2558–2560.

    CAS  PubMed  Google Scholar 

  12. Thomas D, Thomas R, Muliyil JP, George R. Role of frequency doubling perimetry in detecting neuro-ophthalmic visual field defects. Am J Ophthalmol 2001;131:734–741.

    CAS  Article  PubMed  Google Scholar 

  13. Wall M, Neahring RK, Woodward KR. Sensitivity and specificity of frequency doubling perimetry in neuro-ophthalmic disorders: a comparison with conventional automated perimetry. Invest Ophthalmol Vis Sci 2002;43:1277–1283.

    PubMed  Google Scholar 

  14. Bartley GB, Gorman CA. Diagnostic criteria for Graves’ ophthalmopathy. Am J Ophthalmol 1995;119:792–795.

    CAS  Article  PubMed  Google Scholar 

  15. Tsukamoto H, Mukai S, Iwase A, Mishima HK. Recovery of reliability by retest after a 5-minute interval in frequency doubling technology perimetry. Jpn J Ophthalmol 2006;50:380–382.

    Article  PubMed  Google Scholar 

  16. Adams CW, Bullimore MA, Wall M, Fingeret M, Johnson CA. Normal aging effects for frequency doubling technology perimetry. Optom Vis Sci 1999;76:582–587.

    CAS  Article  PubMed  Google Scholar 

  17. Anderson AJ, Johnson CA. Frequency-doubling technology perimetry. Ophthalmol Clin North Am 2003;16:213–225.

    Article  PubMed  Google Scholar 

  18. Sample PA, Bosworth CF, Blumenthal EZ, Girkin C, Weinreb RN. Visual function-specific perimetry for indirect comparison of different ganglion cell populations in glaucoma. Invest Ophthalmol Vis Sci 2000;41:1783–1790.

    CAS  PubMed  Google Scholar 

  19. Sackett DL, Haynes RB, Gyatt GH, Tugwell P. Clinical epidemiology. Houston: Little, Brown & Company; 1991. p. 1–441.

    Google Scholar 

  20. Kennerdell JS, Rosenbaum AE, El-Hoshy MH. Apical optic nerve compression of dysthyroid optic neuropathy on computed tomography. Arch Ophthalmol 1981;99:807–809.

    CAS  Article  PubMed  Google Scholar 

  21. Trobe JD, Glaser JS, Laflamme P. Dysthyroid optic neuropathy. Clinical profile and rationale for management. Arch Ophthalmol 1978;96:1199–1209.

    CAS  Article  PubMed  Google Scholar 

  22. Tsaloumas MD, Good PA, Burdon MA, Misson GP. Flash and pattern visual evoked potentials in the diagnosis and monitoring of dysthyroid optic neuropathy. Eye 1994;8:638–645.

    Article  PubMed  Google Scholar 

  23. Spadea L, Bianco G, Dragani T, Balestrazzi E. Early detection of P-VEP and PERG changes in ophthalmic Graves’ disease. Graefes Arch Clin Exp Ophthalmol 1997;235:501–505.

    CAS  Article  PubMed  Google Scholar 

  24. Acaroglu G, Simsek T, Ozalp S, Mutluay A. Subclinical optic neuropathy in Graves’ orbitopathy. Jpn J Ophthalmol 2003;47:459–462.

    Article  PubMed  Google Scholar 

  25. Salvi M, Spaggiari E, Neri F, et al. The study of visual evoked potentials in patients with thyroid-associated ophthalmopathy identifies asymptomatic optic nerve involvement. J Clin Endocrinol Metab 1997;82:1027–1030.

    CAS  PubMed  Google Scholar 

  26. Ambrosio G, Ferrara G, Vitale R, De Marco R. Visual evoked potentials in patients with Graves’ ophthalmopathy complicated by ocular hypertension and suspect glaucoma or dysthyroid optic neuropathy. Doc Ophthalmol 2003;106:99–104.

    Article  PubMed  Google Scholar 

  27. Dayan CM, Dayan MR. Dysthyroid optic neuropathy: a clinical diagnosis or a definable entity? Br J Ophthalmol 2007;91:409–410.

    Article  PubMed  PubMed Central  Google Scholar 

  28. McKeag D, Lane C, Lazarus JH, et al. Clinical features of dysthyroid optic neuropathy: a European Group on Graves’ Orbitopathy (EUGOGO) survey. Br J Ophthalmol 2007;91:455–458.

    Article  PubMed  Google Scholar 

  29. Fong KC, Byles DB, Constable PH. Does frequency doubling technology perimetry reliably detect neurological visual field defects? Eye 2003;17:330–333.

    CAS  Article  PubMed  Google Scholar 

  30. Gardiner SK, Anderson DR, Fingeret M, McSoley JJ, Johnson CA. Evaluation of decision rules for frequency-doubling technology screening tests. Optom Vis Sci 2006;83:432–437.

    Article  PubMed  Google Scholar 

  31. Heeg GP, Blanksma LJ, Hardus PL, Jansonius NM. The Groningen Longitudinal Glaucoma Study. I. Baseline sensitivity and specificity of the frequency doubling perimeter and the GDx nerve fibre analyser. Acta Ophthalmol Scand 2005;83:46–52.

    Article  PubMed  Google Scholar 

  32. Heeg GP, Stoutenbeek R, Jansonius NM. Strategies for improving the diagnostic specificity of the frequency doubling perimeter. Acta Ophthalmol Scand 2005;83:53–56.

    Article  PubMed  Google Scholar 

  33. Casson R, James B, Rubinstein A, Ali H. Clinical comparison of frequency doubling technology perimetry and Humphrey perimetry. Br J Ophthalmol 2001;85:360–362.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  34. Fogagnolo P, Mazzolani F, Rossetti L, Orzalesi N. Detecting glaucoma with frequency-doubling technology perimetry: a comparison between N-30 and C-20 screening programs. J Glaucoma 2005;14:485–491.

    Article  PubMed  Google Scholar 

  35. Kalaboukhova L, Lindblom B. Frequency doubling technology and high-pass resolution perimetry in glaucoma and ocular hypertension. Acta Ophthalmol Scand 2003;81:247–252.

    Article  PubMed  Google Scholar 

Download references

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Correspondence to Mário L. R. Monteiro.

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Monteiro, M.L.R., Portes, A.L.F., Moura, F.C. et al. Using frequency-doubling perimetry to detect optic neuropathy in patients with Graves’ orbitopathy. Jpn J Ophthalmol 52, 475–482 (2008). https://doi.org/10.1007/s10384-008-0579-x

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  • DOI: https://doi.org/10.1007/s10384-008-0579-x

Key Words

  • dysthyroid optic neuropathy
  • frequency-doubling perimetry
  • Graves’ orbitopathy
  • visual field defect