1. Refinement of the Constellation of Findings at presentation
Clinical and Soft-Tissue Computed Tomographic Predictors of Dysthyroid Optic Neuropathy
Refinement of the Constellation of Findings at presentation
R4 한재형/Pf.양석우

2. Dysthyroid optic neuropathy
5% of cases
Serious complication of TAO leading to vision loss
Accurate and prompt recognition and management is essential.

3. Pathogenesis Compression of optic nerve Deceased blood supply
Retrobulbar pressure
Optic nerve stretch

4. Risk factor
Aging
Male
Diabetes mellitus

5. Diagnostic clues Visual acuity RAPD Color vision Visual field
Evoked Potential

6. Clinical examinations
Inflammatory score of the VISA scale

7. Clinical examinations
Marginal reflex distance
Lower eyelid retraction
Lagophthalmos
Levator function
Interpalpebral fissure distance
Epitheial keratopathy
Fat prolapse
Total ductions
Intraocular pressure in different gaze

8. Radiologic examinations
Apical crowding
Normal Mild, 1%-25%
Moderate, 26%-50% Severe, >50%

9. Radiologic examinations
Proptosis
perpendicular line from the scleral margin to the interzygomatic line on axial scans
Maximum optic nerve sheath diameter
Lacrimal gland displacement
Low-density foci in the extraocular muscles
Superior ophthalmic vein margin irregularity
Presence of tendon enlargement
Anteriorposterior globe diameter
Intracranial fat prolapse

10. Results
189 orbits from 99 consecutive patients

13. Discussions Marginal reflex distance Interpalpebral fissures
Levator function
Newly statistically confirmed parameters in this study
Small hypodensities
fibroblasts into adipocytes
These occur in the later stages of disease
inactive phase of the disease

14. Conclusion Clinical features CT evaluation
are able to predict the presence of DON with high sensitivity, specificity, PPV and NPV.

15. Thank-you for your attentions.