Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Munich Cancer Registry, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University, Munich, Germany.
Orbit. 2023 Oct;42(5):475-480. doi: 10.1080/01676830.2022.2123929. Epub 2022 Sep 21.
To evaluate the findings of visual evoked potentials (VEP) in patients with dysthyroid optic neuropathy (DON).
In this observational, cross-sectional study 40 eyes (22 patients) with a diagnosis of DON were included.
We discovered that in 16 out of 37 eyes with pattern-VEP (-VEP), the latency of P100 wave was normal in spite of having a diagnosis of DON. The same pattern was also observed in the measurement of the amplitude of P100 wave: in 28 out of 37 eyes with p-VEP the amplitudes were observed as normal. In 3 eyes of 3 patients p-VEP showed no response, therefore a flash-VEP (f-VEP) was performed. Flash-VEPs of those patients indicated a prolonged P100 latency with a reduced amplitude. The sensitivity of abnormal P100 latency was 56.8% (95%CI 39.5-72.9%); and that of reduced P100 amplitude was 24.3% (95%CI 11.8-41.2%). Also, in 40 eyes color vision test by Arden was performed. In 36 eyes (20 patients) the tritan value was pathological (based on a threshold of ≥8%).
According our data, VEP seems to have a limited potential especially in patients with a good best-corrected visual acuity (BCVA ≤0.2 LogMAR) for identifying the optic nerve involvement. The fact that P100 latency and amplitude were normal even in cases with an optic nerve swelling makes us question the usefulness of the VEP for diagnosing cases of DON in daily clinical life.
评估甲状腺相关眼病性视神经病变（DON）患者视觉诱发电位（VEP）的结果。
在这项观察性、横断面研究中，纳入了 22 例患者的 40 只眼（均诊断为 DON）。
我们发现，在 37 只具有图形视觉诱发电位（p-VEP）的眼中，有 16 只尽管被诊断为 DON，但 P100 波潜伏期正常。在测量 P100 波振幅时也观察到了同样的模式：在 37 只具有 p-VEP 的眼中，有 28 只的振幅被观察为正常。在 3 例 3 只眼中，p-VEP 无反应，因此进行了闪光视觉诱发电位（f-VEP）检查。这些患者的 f-VEP 显示 P100 潜伏期延长，振幅降低。异常 P100 潜伏期的灵敏度为 56.8%（95%CI 39.5-72.9%）；P100 振幅降低的灵敏度为 24.3%（95%CI 11.8-41.2%）。此外，对 40 只眼进行了 Arden 色觉测试。在 36 只眼（20 例）中，三原色值异常（基于阈值≥8%）。
根据我们的数据，VEP 似乎潜力有限，特别是对于那些最佳矫正视力（BCVA≤0.2 LogMAR）良好的患者，用于识别视神经受累。即使在视神经肿胀的情况下，P100 潜伏期和振幅正常，这使我们对 VEP 在日常临床实践中诊断 DON 病例的有用性产生了质疑。
