Optic Nerve Stretch in Dysthyroid Optic Neuropathy: A Systematic Review and Meta-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.
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.
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.
seen more often in eyes affected by this optic nerve damage than unaffected eyes
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.
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.
While optic-nerve stretch is frequently observed in dysthyroid optic neuropathy, current evidence does not establish it as an independent cause.
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.