Optical Coherence Tomography Features and Correlation of Functional and Structural Parameters in Patients of Idiopathic Intracranial Hypertension

Overview

Journal Indian J Ophthalmol

Specialty Ophthalmology

Date 2022 Mar 25

PMID 35326052

Authors

Mousumi Banerjee

Swati Phuljhele

Gunjan Saluja

Pawan Kumar

Rohit Saxena

Pradeep Sharma

Deepti Vibha

Awadh Kishor Pandit

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine the correlation between functional parameters and optical coherence tomography (OCT) features in patients of idiopathic intracranial hypertension (IIH).

Methods: A prospective observational study in early and established cases of papilledema in IIH presenting from December 2017 to February 2019. Functional parameters (visual acuity, contrast sensitivity, mean deviation, VER, and MfERG) and structural parameters (RNFL, GCL-IPL, and optic disc height) were measured at baseline and every 6 weeks for 6 months.

Results: At baseline, average RNFL had a moderate negative correlation with mean deviation (r = -0.45; P = 0.0007) and a positive correlation with logMAR visual acuity (r = 0.18; P = 0.17). On the contrary, baseline GCL and logMAR visual acuity had a negative correlation (r = -0.4, P = 0.02). Optic disc height (ODH) had a negative correlation with visual field mean deviation (r = -0.046; P = 0.0005). At 6 months, ODH and GCL-IPL complex had a statistically significant correlation with functional parameters. However, RNFL values did not show any significant correlation with any of the functional parameters. Baseline GCL-IPL and optic disc height values had a moderate and significant correlation with final functional parameters. However, RNFL did not show any correlation with final functional parameters. Correlation between GCL-IPL thickness at 6 weeks and final functional parameters were stronger than that with baseline GCL values.

Conclusion: In the setting of severe papilledema, RNFL can misguide the prognosis. GCL-IPL can be a valuable tool for an objective evaluation of the integrity of the optic nerve in IIH and ODH may be used as an alternative or in combination with GCL-IPL in these cases.

Citing Articles

Exploring the utility of retinal optical coherence tomography as a biomarker for idiopathic intracranial hypertension: a systematic review.

Senthil M, Anand S, Chakraborty R, Bordon J, Constable P, Brown S J Neurol. 2024; 271(8):4769-4793.

PMID: 38856724 PMC: 11319609. DOI: 10.1007/s00415-024-12481-3.

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

Bassi S, Pamu R, Ambika S, Praveen S, Priyadarshini D, Dharini V Indian J Ophthalmol. 2024; 72(5):672-676.

PMID: 38189420 PMC: 11168544. DOI: 10.4103/IJO.IJO_1648_23.

Optic Nerve Head Changes Measured by Swept Source Optical Coherence Tomography and Angiography in Patients with Intracranial Hypertension.

Wang H, Cao L, Kwapong W, Liu G, Wang R, Liu J Ophthalmol Ther. 2023; 12(6):3295-3305.

PMID: 37792243 PMC: 10640446. DOI: 10.1007/s40123-023-00822-w.

References

Savini G, Bellusci C, Carbonelli M, Zanini M, Carelli V, Sadun A . Detection and quantification of retinal nerve fiber layer thickness in optic disc edema using stratus OCT. Arch Ophthalmol. 2006; 124(8):1111-7. DOI: 10.1001/archopht.124.8.1111. View

Rebolleda G, Munoz-Negrete F . Follow-up of mild papilledema in idiopathic intracranial hypertension with optical coherence tomography. Invest Ophthalmol Vis Sci. 2008; 50(11):5197-200. DOI: 10.1167/iovs.08-2528. View

Huang-Link Y, Eleftheriou A, Yang G, Johansson J, Apostolou A, Link H . Optical coherence tomography represents a sensitive and reliable tool for routine monitoring of idiopathic intracranial hypertension with and without papilledema. Eur J Neurol. 2018; 26(5):808-e57. DOI: 10.1111/ene.13893. View

Kardon R . Role of the macular optical coherence tomography scan in neuro-ophthalmology. J Neuroophthalmol. 2011; 31(4):353-61. PMC: 3226727. DOI: 10.1097/WNO.0b013e318238b9cb. View

Waisbourd M, Leibovitch I, Goldenberg D, Kesler A . OCT assessment of morphological changes of the optic nerve head and macula in idiopathic intracranial hypertension. Clin Neurol Neurosurg. 2011; 113(10):839-43. DOI: 10.1016/j.clineuro.2011.05.015. View

Auinger P, Durbin M, Feldon S, Garvin M, Kardon R, Keltner J . Baseline OCT measurements in the idiopathic intracranial hypertension treatment trial, part I: quality control, comparisons, and variability. Invest Ophthalmol Vis Sci. 2014; 55(12):8180-8. PMC: 4266084. DOI: 10.1167/iovs.14-14960. View

Friedman D, Jacobson D . Diagnostic criteria for idiopathic intracranial hypertension. Neurology. 2002; 59(10):1492-5. DOI: 10.1212/01.wnl.0000029570.69134.1b. View

Chen J, Thurtell M, Longmuir R, Garvin M, Wang J, Wall M . Causes and Prognosis of Visual Acuity Loss at the Time of Initial Presentation in Idiopathic Intracranial Hypertension. Invest Ophthalmol Vis Sci. 2015; 56(6):3850-9. PMC: 4697859. DOI: 10.1167/iovs.15-16450. View

Bianchi Marzoli S, Ciasca P, Curone M, Cammarata G, Melzi L, Criscuoli A . Quantitative analysis of optic nerve damage in idiopathic intracranial hypertension (IIH) at diagnosis. Neurol Sci. 2013; 34 Suppl 1:S143-5. DOI: 10.1007/s10072-013-1373-1. View

10.

Sibony P, Kupersmith M, Rohlf F . Shape analysis of the peripapillary RPE layer in papilledema and ischemic optic neuropathy. Invest Ophthalmol Vis Sci. 2011; 52(11):7987-95. PMC: 3220412. DOI: 10.1167/iovs.11-7918. View

11.

Skau M, Sander B, Milea D, Jensen R . Disease activity in idiopathic intracranial hypertension: a 3-month follow-up study. J Neurol. 2010; 258(2):277-83. DOI: 10.1007/s00415-010-5750-x. View

12.

Athappilly G, Garcia-Basterra I, Machado-Miller F, Hedges T, Mendoza-Santiesteban C, Vuong L . Ganglion Cell Complex Analysis as a Potential Indicator of Early Neuronal Loss in Idiopathic Intracranial Hypertension. Neuroophthalmology. 2019; 43(1):10-17. PMC: 6351016. DOI: 10.1080/01658107.2018.1476558. View

13.

. Papilledema Outcomes from the Optical Coherence Tomography Substudy of the Idiopathic Intracranial Hypertension Treatment Trial. Ophthalmology. 2015; 122(9):1939-45.e2. PMC: 4549202. DOI: 10.1016/j.ophtha.2015.06.003. View

14.

Kupersmith M, Sibony P, Mandel G, Durbin M, Kardon R . Optical coherence tomography of the swollen optic nerve head: deformation of the peripapillary retinal pigment epithelium layer in papilledema. Invest Ophthalmol Vis Sci. 2011; 52(9):6558-64. PMC: 3175986. DOI: 10.1167/iovs.10-6782. View