ECE2018 Poster Presentations: Thyroid Thyroid (non-cancer) (105 abstracts)
Visual evoked potentials in the diagnosis of orbitopathy during the course of Graves’ disease
Maria Teresa Płazińska 1 , Małgorzata Zgorzalewicz-Stachowiak 2 , Agata Czarnywojtek 3, , Krzesisława Komar-Rychlicka 5 , Krystyna Zeńczak-Praga 2 , Nadia Sawicka-Gutaj 3 , Barbara Czarnocka 6 , Kosma Woliński 3 & Marek Ruchała 3
1Nuclear Medicine Department, Medical University of Warsaw, Warsaw, Poland; 2Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, University of Medical Sciences, Poznan, Poland; 3Chair and Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland; 4Department of Pharmacology, Poznan University of Medical Sciences, Poznan, Poland; 5Department of Ophthalmology, Poznan University of Medical Sciences, Poznan, Poland; 6Department of Biochemistry and Molecular Biology, Centre of Postgraduate Medical Education, Warsaw, Poland.
Graves’ disease (GD) is an autoimmunological disorder leading most often to hyperthyroidism and invasive-edema ophthalmopathy (Graves ophthalmopathy – GO).
Aim: Estimation of visual evoked potentials (VEP) results with the indicators of activity and advancement of the progress of GO.
Materials and methods: The examined group consisted of 100 patients between the ages of 31 and 77, hospitalized in the Department of Endocrinology and Metabolism. The duration of GD from the first clinical signs to the start of treatment was between 3 months to 20 years. Changes in the eye due to GO occurred from 3 months to 6 years. VEPs were carried out according to the recommendations of the International Federation of Clinical Neurophysiology. Latencies and amplitudes of VEP components were compared to normal values in a group of 30 healthy person without an autoimmunological thyroid disorder.
Results: According to the NOSPECS scale, 9 patients showed no visual symptoms. In 17 cases, class 1 or 2 was diagnosed. Furthermore, in 74 patients classes between 3 and 6 were observed. A possible loss of vision due to the visual nerve damage (class 6) was found only in 4 patients. The CAS criteria in 8 patients were equal to 0, and in the remaining 14 patients from 1 to 3. Active GO was diagnosed in 47 patients. In 74 patients, abnormal VEPs were recorded. Normal parameters of VEP were observed only in 26 patients. These were patients with inactive or mild processes involving eye balls. Changes in the latency of P100 increased from 125 ms in mild to 127 ms in intermediate and 129 ms in intense GO. Referring to the control group, a statistical change was observed in the latency of P100 and N145. It was prolonged already in the mild occurrence of GO which confirmed subclinical visual nerve involvement.
Conclusions: VEP can be helpful in the diagnosing of visual nerve neuropathy in patients with GD. The clinical interpretation of changes of P100 and N145 latency is very important in patients with GO.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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