Abstract
Our experience of patients with dysthyroid eye disease shows that normal chromatic discrimination sensitivity precludes the diagnosis of optic nerve compression (31 patients), and that clinically confirmed optic nerve compression is invariably associated with decreased chromatic discrimination sensitivity thresholds (8 patients). Dysthyroid patients enrolled in this study underwent automated achromatic contrast and chromatic discrimination sensitivity testing on presentation, with repeat assessment of those patients suspected of developing optic nerve compression. If chromatic discrimination sensitivity was decreased, patients were followed up more frequently. If abnormal chromatic discrimination sensitivity was accompanied by a relative afferent pupillary defect (RAPD) or decreased Snellen visual activity (VA), then optic nerve decompression was performed. The automated chromatic discrimination sensitivity test described represents a quick, reproducible and cheap clinical test which we feel is of value in assessing patients with dysthroid eye disease. We suggest that sequential chromatic discrimination sensitivity assessment is a sensitive and effective way of monitoring patients at risk of dysthyroid optic neuropathy.
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References
Weetman AP . Thyroid-associated eye disease: pathophysiology. Lancet 1991;338:25–8.
Trobe JD, Glaser JS, Laflamme P . Dysthyroid optic neuropathy: clinical profile and rationale for management. Arch Ophthalmol 1978;96:1199–209.
Suttorp-Schulten MSA, Tijsen R, Mounts MPH, Apkarian P . Contrast sensitivity function in Graves' ophthalmopathy and dysthyroid optic neuropathy. Br J Ophthalmol 1993;77:709–12.
Mounts MPH, Suttorp-Schulten MSA, Tijsen R, Apkarian P . Contrast sensitivity and the diagnosis of dysthyroid optic neuropathy. Doc Ophthalmol 1990;74:329–35.
Weatherill J, Yap M . Recovery of contrast sensitivity following bilateral orbital decompression: a case report. Am J Optom Phys Optics 1985;62:715–9.
Potts MJ, Fells P, Falcao-Reis F, Bucetti S, Arden GB . Colour contrast sensitivity, pattern ERGs and cortical evoked potentials in dysthyroid optic neuropathy. Invest Ophthalmol Vis Sei 1990;31:189.
Werner SC . Classification of the eye changes of Graves' disease. J Clin Endocrinol Metab 1969;29:782.
de Alwis DV, Reffin JP, Tregear SJ, Casswell AG, Ripley LG . Should management of diabetic retino-pathy be based upon measurements of visual function rather than observations of retinal morphology? Invest Ophthalmol Vis Sci 1993;34:719.
Reffin JP . The design and clinical application of tests of colour vision. DPhil thesis, University of Sussex, Falmer, Brighton, UK, 1991.
Tregear SJ, Knowles PJ, Ripley LG, Casswell AG . Colour vision deficits predict the development of severe diabetic retinopathy in diabetic subjects with background retinopathy. Invest Ophthalmol Vis Sci 1993;34:719.
Tregear SJ, Ripley LG, Knowles PJ, Gilday RT, de Alwis DV, Reffin JP . Automated Tritan Discrimination: a new clinical technique for the effective screening of severe diabetic retinopathy. Int J Psychophys 1994;16:191–8.
Cornsweet TN . The staircase method in psychophysics. Am J Psychol 1962;75:485–91.
Jindra LF, Zemon V . Contrast sensitivity testing: a more complete assessment of vision. J Cataract Refract Surg 1989;15:141–7.
Arden GB . Visual loss in patients with a normal visual acuity. Trans Ophthalmol Soc UK 1978;98:219–31.
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Tanner, V., Tregear, S., Ripley, L. et al. Automated achromatic contrast and chromatic discrimination sensitivity testing in dysthyroid optic neuropathy. Eye 9, 352–357 (1995). https://doi.org/10.1038/eye.1995.69
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DOI: https://doi.org/10.1038/eye.1995.69