Volume 52, Number 6, 475-482, DOI: 10.1007/s10384-008-0579-x

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Japanese Ophthalmological Society

Using frequency-doubling perimetry to detect optic neuropathy in patients with Graves’ orbitopathy

Mário L. R. Monteiro, André L. F. Portes, Frederico C. Moura and Dina B. W. Regensteiner

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Abstract

Purpose  

to test the ability of frequency-doubling technology (FDT) perimetry to detect dysthyroid optic neuropathy (DON).

Methods  

Fifteen eyes of 15 patients with DON and 15 healthy control eyes were studied. Eligible eyes had a diagnosis of DON based on visual field abnormalities on standard automated perimetry and had visual acuity better than 20/30. FDT testing was performed using both the C-20-5 screening test and the C-20 full-threshold test. Normal and DON eyes were compared with regard to FDT mean sensitivity.

Results  

Sensitivity ranges were 40.0%–86.7% for the screening test, and 53.3%–100.0% (total deviation) and 20.0–93.3 (pattern deviation) for the C-20 threshold test. The corresponding specificity ranges were 86.7–100.0, 33.3–93.3, and 26.7–100.0, respectively. The best sensitivity/specificity ratios were for one abnormal point depressed <5% in the screening test (86.7%/86.7%), one point depressed <1% in the total deviation analysis (80.0%/86.7%), and one point depressed <2% in the pattern deviation analysis (80.0%/86.7%). DON eyes presented significantly lower than normal average sensitivity in the central, pericentral, and peripheral areas.

Conclusions  

FDT perimetry is a useful screening tool for DON in eyes with normal or only slightly reduced visual acuity.

Key Words  dysthyroid optic neuropathy - frequency-doubling perimetry - Graves’ orbitopathy - visual field defect

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