Predicting dysthyroid optic neuropathy in moderate-to-severe thyroid eye disease: a clinically applicable nomogram
Authors' conclusion
Altogether, the findings of this study identify advanced age, elevated CAS, increased TG, lower VF, and PTM as significant predictors of DON in patients with TED. The proposed nomogram offers a practical clinical tool for risk stratification, providing clinicians with an approach for individualized risk assessment and timely therapeutic intervention.
Study context
- Population
- Patients with moderate-to-severe thyroid eye disease (TED)68 (26.5%) developed dysthyroid optic neuropathy (DON)
- Participants
- 257 patients
- Exposure
- Derivation vs Validation
- Derivationn = 185
- Outcome
- Development of dysthyroid optic neuropathy (DON); prediction model for early identification of high-risk cases
Methodological detailsprediction model development and validation, derivation and validation cohorts, Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression, nomogram
- Prediction model development and validation
- Derivation and validation cohorts
- LASSO and logistic regression
- Nomogram
Main finding
As reported in the abstract
Nomogram discrimination for DON
| Group | AUC |
|---|---|
| Derivation | 0.853 (95% CI: 0.792-0.914) |
| Validation | 0.856 (95% CI: 0.762-0.950) |
AUC
Derivation0.853 (95% CI: 0.792-0.914)
Validation0.856 (95% CI: 0.762-0.950)
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Characteristics of DON vs non-DON patients, derivation cohort (49 of 185, 26.5% developed DON)DON vs Non-DON · PTM 22.4 vs 5.9% | P = 0.001 |
| Characteristics of DON vs non-DON patients, derivation cohort (49 of 185, 26.5% developed DON)DON vs Non-DON · DM 18.4 vs 7.4% | P = 0.029 |
| Characteristics of DON vs non-DON patients, derivation cohort (49 of 185, 26.5% developed DON)DON vs Non-DON · Age 58.04 ± 11.30 years vs 47.99 ± 10.65 years | P < 0.001 |
| Characteristics of DON vs non-DON patients, derivation cohort (49 of 185, 26.5% developed DON)DON vs Non-DON · CAS 5 vs 4 | P < 0.001 |
| Characteristics of DON vs non-DON patients, derivation cohort (49 of 185, 26.5% developed DON)DON vs Non-DON · TG 1.44 mmol/L vs 1.15 mmol/L | P = 0.042 |
| Characteristics of DON vs non-DON patients, derivation cohort (49 of 185, 26.5% developed DON)DON vs Non-DON · Lower VF: 43.75 vs 62.50 | P < 0.001 |
Original publication
Predicting dysthyroid optic neuropathy in moderate-to-severe thyroid eye disease: a clinically applicable nomogram. Eur Thyroid J. Published 8 December 2025. doi:10.
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