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      Contrast Sensitivity of Thyroid Associated Ophthalmopathy Patients without Obvious Optic Neuropathy


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          Purpose. To compare the contrast sensitivity levels of thyroid associated ophthalmopathy (TAO) patients without obvious optic neuropathy with those of healthy people. Methods. Forty eyes of 20 TAO patients without dysthyroid optic neuropathy and 40 eyes of 20 healthy subjects were evaluated in this prospective case-controlled study. The contrast sensitivity functions (CSFs) of all subjects were measured by the functional acuity contrast test (FACT) in five frequencies which were 1,5 cpd (A), 3 cpd (B), 6 cpd (C), 12 cpd (D), and 18 cpd (E). Results were compared for both groups, and a correlation of CSF with Hertel and clinical activity scores was assessed. Results. There was no statistically significant difference between TAO patients and control groups for age and sex. TAO patients had lower levels than the control group in all the frequencies of CSFs ( P < 0.05) and the difference in contrast sensitivity functions between the groups seems to be more significant in higher frequencies (B, C, D, and E) ( P < 0.001). Conclusions. TAO patients without DON can have contrast sensitivity loss and this would probably imply subtle optic nerve dysfunction in early disease phase.

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          Test-retest reliability of the CSV-1000 contrast test and its relationship to glaucoma therapy.

          To determine the relationship between changes in contrast sensitivity, if any, after glaucoma therapy and the test-retest reliability of the CSV-1000 contrast sensitivity test. Patients with primary open angle glaucoma (N = 16) were retrospectively evaluated to determine changes in visual function, as measured by contrast sensitivity, after beta-blocker therapy. A control group (N = 24) of normally sighted patients was tested and retested on contrast sensitivity. For the control group, the coefficients of repeatability (95% confidence interval for test-retest variability [COR]) were calculated for each spatial frequency. The CORs were compared to the changes in vision found after therapy in the patients with glaucoma. The group with glaucoma showed a significant improvement (P < .01) in contrast sensitivity at all spatial frequencies. The test-retest variance for normals, as measured by the COR, was smaller than the mean differences in contrast sensitivity before and after therapy at all spatial frequencies, expect 18 cyc/deg. Visual function in patients with glaucoma, as measured by contrast sensitivity, does improve after beta-blocker therapy. Further, the CSV-1000 is a clinically reliable tool for monitoring these changes.
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            Dysthyroid optic neuropathy. The crowded orbital apex syndrome.

            The authors have reviewed the clinical presentation, visual fields, color vision testing, visual-evoked potentials, and computed tomographic (CT) findings of 58 patients (95 eyes) with dysthyroid optic neuropathy. The authors compared these findings to a control group of 60 patients (119 eyes) with thyroid eye disease who underwent CT scanning and did not exhibit evidence of optic neuropathy. Clinically, dysthyroid optic neuropathy is an insidious disease; when compared with the usual Graves' orbitopathy patient, the optic neuropathy group presented at a later age and with a later onset of thyroid eye disease. The patients in this group were more likely to be male and/or diabetic, and often presented with desaturation of color vision. Asymmetrical extraocular muscle restriction and vertical tropias were more frequent in the optic neuropathy group. The most sensitive indicators of optic nerve dysfunction appeared to be visual-evoked potentials and color vision. Computed tomographic studies confirmed that apical orbital crowding was a characteristic feature of optic neuropathy. These findings should alert the clinician to a more aggressive approach to these patients.
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              Classification of the eye changes of Graves' disease.


                Author and article information

                The Scientific World Journal
                Hindawi Publishing Corporation
                24 December 2013
                : 2013
                : 943789
                1Department of Ophthalmology, Memorial Hospital, Istanbul, Turkey
                2Department of Ophthalmology, Ahi Evran University, Kırşehir, Turkey
                3Department of Ophthalmology, Erzincan University, Mengücek Gazi Training and Research Hospital, Göz Hastalıkları, 24000 Erzincan, Turkey
                4Department of Ophthalmology, Dünya Göz Hospital, Samsun, Turkey
                Author notes

                Academic Editors: Z. Bashshur, J. E. Lee, and L. Wu

                Copyright © 2013 Ümit Beden et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 4 August 2013
                : 9 October 2013
                Clinical Study



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