ArticleClinical ophthalmology (Auckland, N.Z.)2026
Clinical Spectrum of Neuro-Ophthalmic Disorders at a Thai Tertiary Referral Center: An 11-Year Retrospective Study.
Article in Clinical ophthalmology (Auckland, N.Z.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To characterize the diagnostic spectrum of a tertiary neuro-ophthalmology service in Thailand and to describe the etiologic distribution of selected H47-coded optic nerve and optic disc records after chart-based adjudication. Patients and Methods: We conducted a retrospective service-based study of outpatient (OPD) and inpatient (IPD) neuro-ophthalmic records from January 2015 through December 2025. Analyses distinguished unique individuals, setting-specific patient-year records, patient-year-category records, and individual diagnostic records. H46-coded optic neuritis records were retained as code-based diagnoses; selected H47-coded records underwent manual chart adjudication by a fellowship-trained neuro-ophthalmologist using prespecified criteria. Annual analyses combined OPD and IPD after same-person/same-year cross-setting deduplication. Results: The dataset contained 1533 OPD and 504 IPD setting-specific patient-year records, representing 1815 unique individuals overall and 1905 cross-setting patient-years. Optic nerve and optic disc disorders occurred in 769/1,533 OPD patient-years (50.2%; 95% CI, 47.7-52.7) and 302/504 IPD patient-years (59.9%; 95% CI, 55.6-64.1). At the diagnostic-record level, 1076 optic nerve/disc records were identified: 344 H46-coded optic neuritis records and 732 selected H47-coded records with chart-based final classification. The most frequent diagnostic records were optic neuritis (344, 32.0%), optic atrophy/optic neuropathy NOS (230, 21.4%), ischemic optic neuropathy (111, 10.3%), optic disc cupping/glaucoma suspect (102, 9.5%), traumatic optic neuropathy (94, 8.7%), and compressive optic neuropathy (76, 7.1%). Optic nerve/disc disorders were the numerically largest category in every study year, accounting for 47.2%-58.3% of annual cross-setting patient-years. Conclusion: In this single-center service-based dataset, optic nerve and optic disc diagnoses were the most frequently recorded neuro-ophthalmic category. Manual chart review of selected H47-coded records enabled more detailed etiologic grouping, while H46-coded optic neuritis remained a code-based subgroup. The findings describe local tertiary referral practice and should be externally validated before generalizing the classification approach across institutions.
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