Thyroid-Associated Ophthalmopathy: Preliminary Study Using T2 Mapping to Characterize Intraorbital Optic Nerve Changes Before Dysthyroid Optic Neuropathy.

Abstract

OBJECTIVE:

To evaluate the performance of T2 mapping in detecting intraorbital optic nerve (ON) changes in patients with thyroid-associated ophthalmopathy (TAO) before the onset of dysthyroid optic neuropathy (DON).

METHODS:

Thirty-five patients with TAO and without DON (21 active, 14 inactive) and 21 healthy controls (HCs) were enrolled. Magnetic resonance imaging-derived parameters of T2 relaxation time (T2RT) at the intraorbital ON, extraocular muscle (EOM), orbital fat, exophthalmos, summed thickness of EOMs, orbital fat thickness, and clinical variables were compared. Correlations between T2RT at the ON and other variables were assessed.

RESULTS:

Patients with TAO showed significantly higher T2RTs at the intraorbital ON than HCs (P < .001). Patients with active TAO had significantly higher T2RTs than those with inactive TAO and HCs (P < .001). Differences between patients with inactive TAO and HCs were insignificant (P > .05/3). T2RT at the intraorbital ON was positively correlated with clinical activity score, modified NOSPECS score, T2RT at EOM, exophthalmos, and summed thickness of EOMs in the TAO group (P ≤ .003) and negatively correlated with visual acuity (P = .033) and visual field indices (P = .030) in patients with active TAO. A T2RT cutoff of 82.9 ms for the intraorbital ON distinguished active TAO and healthy eyes optimally (area under the curve, 0.800; sensitivity, 85.7%; specificity, 64.3%).

CONCLUSION:

T2RT detects disturbance in the intraorbital ON in patients with TAO, especially active TAO, before DON develops. T2 mapping has a potential for noninvasive evaluation of ON changes in patients with TAO.

• Authors: Hao Hu, Huan-Huan Chen, Wen Chen, Qian Wu, Lu Chen, Hui Zhu, Hai-Bin Shi, Xiao-Quan Xu, Fei-Yun Wu
• Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (Endocr Pract) Vol. 27 Issue 3 Pg. 191-197 (Mar 2021) ISSN: 1530-891X [Print] United States
• PMID: 33630733 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 AACE. Published by Elsevier Inc. All rights reserved.

Topics

• Graves Ophthalmopathy (diagnostic imaging)
• Humans
• Magnetic Resonance Imaging
• Oculomotor Muscles (diagnostic imaging)
• Optic Nerve (diagnostic imaging)
• Optic Nerve Diseases (diagnostic imaging)