Original articleQuantitative Computed Tomographic Predictors of Compressive Optic Neuropathy in Patients with Thyroid Orbitopathy: A Volumetric Analysis
Section snippets
Methods
A detailed description of the methodology and analysis has previously been published.6 Institutional ethics approval was obtained. In short, a consecutive series of patients evaluated at the University of British Columbia orbit clinic by 1 surgeon (J.R.) were enrolled. Subjects were evaluated using the VISA8 system and required an orbital CT with true axial and either true or coronal reconstructs. The VISA clinical examination scheme evaluates 4 categories: (1) visual function, (2)
Results
Images of 198 orbits from 99 patients were evaluated. Basic demographics are presented in Table 1. The mean exophthalmometry measurement was 20.3 (standard deviation [SD], 4.2) and inflammatory score was 2.1 out of 8 (SD, 1.8), with 15% having “active” disease (VISA inflammatory score ≥3). Nine percent were diagnosed with DON. The mean VISA inflammatory score for orbits with DON was 3.43 (SD, 1.81) and 1.75 (SD, 1.90) for those without DON.
Significant volumetric univariate predictors of DON
Discussion
Because patients can develop DON after their clinical evaluation, and certain patients present with an equivocal diagnosis of DON, a constellation of findings have been developed to aid the physician in defining the “at-risk” patient. Our prior research has shown that careful evaluation and documentation of extraocular motility measurement, ptosis evaluation as measured by marginal reflex distance, and assessment of effacement of the perineural fat at the orbital apex, as measured on coronal CT
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Manuscript no. 2011-1494.
Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.