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. 2024 May 1;72(5):672-676.
doi: 10.4103/IJO.IJO_1648_23. Epub 2024 Jan 8.

Optical coherence tomography in papilledema: A probe into the intracranial pressure correlation

Shikha Talwar Bassi  1 , Ramesh Pamu  2 , Selvakumar Ambika  3 , Smita Praveen  4 , Durga Priyadarshini  4 , Vidhya Dharini  4 , K Padmalakshmi  4
Affiliations

Optical coherence tomography in papilledema: A probe into the intracranial pressure correlation

Shikha Talwar Bassi et al. Indian J Ophthalmol. .

Abstract

Purpose: To study the optic nerve head characteristics on optical coherence tomography (OCT) in patients with papilledema and correlate them with intracranial pressure (ICP).

Methods: A retrospective hospital-based study of 46 eyes of 23 patients with bilateral optic disc edema secondary to increased ICP. The clinical profile and the OCT features in terms of retinal nerve fiber layer thickness (RNFL), ganglion cell inner plexiform layer (GCIPL) thickness, and enhanced depth imaging (EDI) B scan images of the optic nerve head were studied and correlated with the ICP.

Results: Papilledema was secondary to idiopathic intracranial hypertension (IIH) ( n = 20), obstructive hydrocephalus ( n = 2), and communicating hydrocephalus ( n = 1). The mean ICP in 20 IIH patients was 347 mmH 2 O. The ICP and RNFL thickness in all four quadrants were found to be weakly positively correlated: superior RNFL r (38) = 0.17, P = 0.30, and nasal RNFL r (38) = 0.30, P = 0.05, inferior RNFL r (38) = 0.29, P = 0.07, and temporal RNFL, r (38) = -0.001, P = 0.99. The GCIPL layer thickness and the ICP were weakly negatively correlated in all sectors: superior (38) = -0.23, P = 0.16, superonasal, r (38) = -0.07, P = 0.67, inferonasal r (38) = -0.08, P = 0.64, inferior r (38) = -0.21, P = 0.19, inferotemporal r (38) = -0.23, P = 0.17, superotemporal, r (38) -0.21, P = 0.20. Descriptive features on the B scan, such as peripapillary hyperreflective ovoid mass-like structures and microcystic spaces, were observed most commonly with an ICP of 251-350 mmH 2 O, and the hyperreflective dots in the RNFL layer and Bruch's membrane inward denting were observed more commonly with an ICP of 351-450 mmH 2 O.

Conclusion: The RNFL thickness in all four quadrants had a weak positive correlation, and the GCIPL layer had a weak negative correlation with the ICP. The EDI descriptive features on OCT may vary with ICP.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Fundus image and the optical coherence tomography image in an eye with papilledematous optic disc depicting cystic spaces in the inner nuclear layer (red arrow), wavy deformity of the outer plexiform layer, irregular retinal pigment epithelium, peripapillary hyperreflective ovoid mass-like structure, inward denting of Bruch’s membrane (white arrows) (b) Fundus image and the optical coherence tomography image of the same eye (post-treatment of idiopathic intracranial hypertension), the cystic spaces have disappeared
Figure 2
Figure 2
Hyperreflective dots (white arrow) with microcystic spaces (red arrow) in the retinal nerve fiber layer in a case of papilledema
Figure 3
Figure 3
Nasal elevation of the retinal nerve fiber layer in a case of papilledema
Figure 4
Figure 4
Chronic papilledema showing wavy deformity of the inner nuclear and outer plexiform layers (arrow) and the inward denting of the retinal pigment epithelium and Bruch’s membrane retinal pigment epithelium complex (white arrows)
Figure 5
Figure 5
Inward denting of Bruch’s membrane retinal pigment epithelium complex (white arrows)
See this image and copyright information in PMC

References

    1. Hoyt WF, Walsh FB, . Miller NRNewman NJ, , editors. Walsh & Hoyt’s Clinical Neuro Ophthalmology: The Essentials. 2nd. Lippincott Williams & Wilkins; 2008. Papilledema; pp. 122–146.
    1. Malmqvist L, Bursztyn L, Costello F, Digre K, Fraser JA, Fraser C, et al. The Optic disc drusen studies consortium recommendations for diagnosis of optic disc drusen using optical coherence tomography. J Neuroophthalmol. 2018;38:299–307. - PubMed
    1. Huang-Link Y, Eleftheriou A, Yang G, Johansson JM, Apostolou A, Link H, et al. Optical coherence tomography represents a sensitive and reliable tool for routine monitoring of idiopathic intracranial hypertension with and without papilledema. Eur J Neurol. 2019;26:808–e57. doi: 10.1111/ene.13893. - PubMed
    1. Driessen C, Eveleens J, Bleyen I, van Veelen ML, Joosten K, Mathijssen I. Optical coherence tomography: A quantitative tool to screen for papilledema in craniosynostosis. Childs Nerv Syst. 2014;30:1067–73. - PubMed
    1. Nolan RC, Narayana K, Galetta SL, Balcer LJ. Optical coherence tomography for the neurologist. Semin Neurol. 2015;35:564–77. - PubMed