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. 2023 Nov;71(11):3552-3557.
doi: 10.4103/IJO.IJO_3146_22.

Understanding pseudopapilledema on spectral domain optical coherence tomography

Shikha Talwar Bassi  1 , Ramesh Pamu  2 , Anjaly Varghese  3
Affiliations

Understanding pseudopapilledema on spectral domain optical coherence tomography

Shikha Talwar Bassi et al. Indian J Ophthalmol. 2023 Nov.

Abstract

Purpose: Optic nerve head drusen (ONHD), peripapillary hyperreflective ovoid mass-like structures (PHOMS), and horizontal hyperreflective lines (HHL) are commonly seen in eyes with pseudopapilledema on enhanced depth imaging (EDI) spectral domain optical coherence tomography (SDOCT). The objective of this study is to assess the frequency of ONHD, PHOMS, and HHL on spectral domain OCT in the eyes diagnosed to have pseudopapilledema.

Methods: A retrospective case-control study included patients diagnosed as pseudopapilledema and had EDI SD OCT imaging of the optic nerve head (n = 48 eyes) and controls (n = 20 eyes). OCT scans through the optic nerve head were studied to diagnose ONHD, HHL, and PHOMS. One proportion z test was used to find the difference in proportions.

Results: Forty eight eyes of 27 subjects were studied. ONHD as described by the optic disc drusen Studies consortium was noted in 19 eyes (39.48%), P value-0.032, PHOMS in 31 eyes (64.6%), P value 0.043, HL in 19 eyes (39.48%), P value 0.032, and none of the normals had ONHD, PHOMS, and HHL.

Conclusions: PHOMS are more frequently seen than ONHD and HHL in eyes with pseudopapilledema.

Keywords: Optic nerve head drusen; optical coherence tomography; pseudopapilledema.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
(a) Color fundus photograph: Showing the superficial drusen on the disc surface (b) Ultrasound B-scan: Showing a localized very high reflective echo over the optic nerve head persisting even in the low gain suggestive of optic nerve head drusen (c) Spectral domain optical coherence tomography: Showing a cluster of optic nerve head drusen as structures with a hyporeflective core surrounded by the high reflective margins
Figure 2
Figure 2
Peripapillary hyperreflective ovoid mass-like structures: Spectral domain optical coherence tomography of the optic nerve head showing the peripapillary hyperreflective ovoid mass-like structure in the nasal quadrant
Figure 3
Figure 3
Horizontal hyperreflective lines: Spectral domain optical coherence tomography of the optic nerve head showing the horizontal hyperreflective lines below the Bruch's membrane in the absence of peripapillary hyperreflective ovoid mass-like structures and drusen
Figure 4
Figure 4
(a) Depicting the age and the depth of drusen correlation, (b)Depicting the laterality and number of Drusen correlation (c) Showing the disc area in relation to the depth of drusen, and (d) showing the disc area and number of drusen correlation
Figure 5
Figure 5
(a) Showing the mean retinal nerve fiber layer (RNFL) thickness in groups on the basis of disc area, (b) Depicting the mean RNFL thickness and depth of drusen correlation, (c) Showing the mean ganglion cell complex (GCC) thickness in groups on the basis of disc area, and (d) Showing the mean GCC thickness and the depth of drusen correlation
See this image and copyright information in PMC

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Supplementary concepts