Abstract：
Diagnosis of dysthyroid optic neuropathy (DON) typically relies on a set of diagnostic clinical features, including decreased visual acuity, impaired color vision, presence of relative afferent pupillary defect, optic disc swelling and ancillary tests including visual field (VF), pattern visual evoked potential (pVEP), and apical crowding or optic nerve stretching on neuroimaging. We summarize various diagnostic methods to establish or rule out DON. A total of 95 studies (involving 4619 DON eyes) met the inclusion criteria. All of the studies considered clinical features as evidence of DON, while most of the studies confirmed DON diagnosis by combining clinical features with ancillary tests. Forty studies (42.1%) used at least 2 out of the 3 tests (VF, pVEP and neuroimaging) and 13 studies (13.7%) used all 3 tests to diagnose DON. In 64 % of the published studies regarding DON, the diagnostic methods of DON were not specified. It is important to note the limitations of relying solely on clinical features for diagnosing DON. On the other hand, since some eyes with optic neuropathy can be normal in one ancillary test, but abnormal in another, using more than one ancillary test to aid diagnosis is crucial and should be interpreted in correlation with clinical features. We found that the diagnostic methods of DON in most studies involved using a combination of specific clinical features and at least 2 ancillary tests.
摘要：
甲状腺功能异常视神经病变（DON）的诊断通常依赖于一组诊断性临床特征，包括视力下降,色觉受损,存在相对传入瞳孔缺损，视神经盘肿胀和辅助测试，包括视野（VF），模式视觉诱发电位(pVEP)，神经影像学上的根尖拥挤或视神经拉伸。我们总结了各种诊断方法来建立或排除DON。共有95项研究（涉及4619只DON眼）符合纳入标准。所有的研究都认为临床特征是DON的证据，虽然大多数研究通过将临床特征与辅助测试相结合来证实DON的诊断。40项研究(42.1%)使用了3项测试中的至少2项(VF，pVEP和神经影像学）和13项研究（13.7％）使用所有3项测试来诊断DON。在已发表的关于DON的研究中，有64％未说明DON的诊断方法.重要的是要注意仅依靠临床特征来诊断DON的局限性。另一方面,因为一些患有视神经病变的眼睛在一项辅助测试中可能是正常的，但在另一个异常，使用一项以上辅助检查辅助诊断至关重要,应结合临床特征进行解释.我们的研究发现，在大多数研究中，DON的诊断方法涉及使用特定临床特征和至少2项辅助测试的组合。
