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New research · Ophthalmology
Ophthalmic plastic and reconstructive surgery · 1d
Meta-analysisOphthalmic plastic and reconstructive surgery · 2026

Optic Nerve Stretch in Dysthyroid Optic Neuropathy: A Systematic Review and Meta-Analysis.

Anahita Dadali, Isobel Landray, Kaveh Vahdani, Geoffrey E Rose
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OphthalmologyMeta-analysis

Optic nerve stretch is more common in eyes with dysthyroid optic neuropathy than without it.

Optic Nerve Stretch in Dysthyroid Optic Neuropathy: A Systematic Review and Meta-Analysis.

Anahita Dadali … Geoffrey E Rose
Ophthalmic plastic and reconstructive surgery · 2026
Background

To review and assess published imaging evidence for optic nerve stretch (optic nerve stretch) in patients with dysthyroid optic neuropathy (dysthyroid optic neuropathy), evaluating its prevalence, measurement methods, and potential association with disease pathophysiology.

Purpose

To review and assess published imaging evidence for optic nerve stretch (optic nerve stretch) in patients with dysthyroid optic neuropathy (dysthyroid optic neuropathy), evaluating its prevalence, measurement methods, and potential association with disease pathophysiology.

Methods

PubMed, EMBASE, Cochrane CENTRAL, and ClinicalTrials.gov were searched using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, for computerized tomographic or magnetic resonance imaging studies of optic nerve stretch in thyroid eye disease.

n = 6 studies
Results

seen more often in eyes affected by this optic nerve damage than unaffected eyes

56%
DON orbits
31%
non-DON orbits
More results

Sixteen studies, comprising 1,277 orbits (508 dysthyroid optic neuropathy and 769 non-dysthyroid optic neuropathy), met the inclusion criteria.

Five noncomparative studies, mostly earlier papers, report optic nerve stretch in 43% (0%-100%) of 75 dysthyroid optic neuropathy orbits.

More results

Eleven studies (1,202 orbits) compared orbits with and without dysthyroid optic neuropathy: 6 studies examined optic nerve contour (317 dysthyroid optic neuropathy and 435 non-dysthyroid optic neuropathy) and reported optic nerve stretch in 66% of dysthyroid optic neuropathy and 37% of non-dysthyroid optic neuropathy orbits.

“
Conclusion · 1 of 2

While optic-nerve stretch is frequently observed in dysthyroid optic neuropathy, current evidence does not establish it as an independent cause.

Conclusion · 2 of 2

optic nerve stretch may reflect geometric changes due to orbital soft-tissue expansion, and the principal mechanism for dysthyroid optic neuropathy probably remains apical compression and microvascular ischemia of the optic nerve.

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