Neuropatia nerwu wzrokowego w przebiegu oftalmopatii Gravesa ? zależność pomiędzy perymetrią statyczną a wynikami tomografii komputerowej
Optic Neuropathy in the Course of Graves? Ophthalmopathy ? Relationship between Static Perimetry and Computed Tomographic Findings
Jadwiga Janik1, Helena Jastrzębska2, Małgorzata Gietka-Czernel2, Stefan Zgliczyński2, Barbara Rożniatowska3
1Poradnia Okulistyczna i 2Klinika
Endokrynolgii Centrum Medycznego Kształcenia Podyplomowego w
Kierownik: prof. dr hab. med. Stefan Zgliczyński
3Zakład Radiologii i Pracownia Tomografii Komputerowej Szpitala Bielańskiego w Warszawie
Kierownik: lek. med. Krzysztof Lerch
Summary: Purpose: To determine the relationship between visual field defects and extraocular muscle enlargement in optic neuropathy in the course of Graves? ophthalmopathy. Materials and methods: The CT scans of orbit as well as central visual field examination (G1X program, OCTOPUS 1-2-3 Interzeag automated perimeter) were conducted in 45 patients with optic neuropathy. Muscle diameters were measured for each orbit. On the basis of these measurements the muscle diameter index (MI) was calculated. Grades 1, 2 and 3 of the optic nerve crowding at the orbital apex were assessed in coronal planes on CT scans. The relationship between mean defect (MD) in the central visual field and the muscle index value (MI), and the degree (grade 1, 2, 3) of the optic nerve crowding was established. Results: Linear regression analysis showed statistically significant positive relationship (r=0.5; p=0.0001) between the mean defect (MD) and the muscle index (MI). Analysis of the degree of optic nerve crowding at the orbital apex showed that the MD had reached the highest mean value grade 3 of apical crowding. It differs statistically significantly with grades 2 and 1. Conclusions: The linear relationship between the visual field defects and the enlargement of extraocular muscle has been found. The evaluation of the degree of optic nerve crowding at the orbital apex allows estimating the advance of neuropathy.
Keywords: optic neuropathy, Graves? opthalmopathy, automated static perimetry, extraocular muscle ? orbit CT.