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Laser scanning tomography measurement of the extent of papilledema in the follow-up examination of patients with idiopathic intracranial hypertension.
J Neurosurg. 2007 Sep; 107(3):543-7.JN

Abstract

OBJECT

The authors evaluated the characteristics of patients with idiopathic intracranial hypertension (IIH), and compared laser scanning tomography (LST) measurements of papilledema with the clinical parameters and cerebrospinal fluid (CSF) opening pressures obtained.

METHODS

Twenty-four patients were included in this study; these individuals included 21 women and three men with a mean age of 35.5 +/- 9.7 years and a mean body mass index (BMI) of 35.4 +/- 8.3 kg/m2. The authors conducted a prospective follow-up study over a period of 12 months through a series of four consultations with each patient. These patients had a mean time to treatment of 6.2 +/- 7.9 months and, at the time of diagnosis, suffered a mean of 2.8 +/- 1.3 symptoms each. Laser scanning tomography of the optic disc revealed a mean global rim volume of 1.693 +/- 1.662 mm3 and a mean height of 0.604 +/- 0.306 mm. The mean CSF opening pressure was 31.3 +/- 6.3 cm H2O.

RESULTS

During the follow-up period, all patients improved significantly with regard to clinical parameters (p < 0.001), BMI reduction (p < 0.001), and reduction of visual field deficits (p = 0.007); visual acuity remained unchanged. In all patients at each successive consultation, the CSF opening pressure was lower than it had been at the previous consultation (p = 0.001). Laser scanning tomography measurements demonstrated a statistically significant reduction in both optic disc parameters over the follow-up period (global rim volume, p = 0.044; mean height, p = 0.019). The CSF opening pressure and the LST measurements correlated significantly with the number of symptoms (CSF opening pressure, p < 0.001; global rim volume, p = 0.001; mean height, p < 0.001). The mean area under the receiver operating characteristic curve in detecting the presence of clinical symptoms was 0.87 for CSF opening pressure, 0.7 for rim volume, and 0.81 for mean optic disc height.

CONCLUSIONS

Laser scanning tomography measurements are useful for evaluating the degree of papilledema in patients with IIH and correspond well with clinical data and measurements of CSF opening pressure. If a diagnosis of IIH is established, LST measurements may replace repeated CSF opening pressure measurements in follow-up monitoring.

Authors+Show Affiliations

Department of Neurology, University-Hospital Erlangen, Germany. josef.heckmann@uk-erlangen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17886553

Citation

Heckmann, Josef G., et al. "Laser Scanning Tomography Measurement of the Extent of Papilledema in the Follow-up Examination of Patients With Idiopathic Intracranial Hypertension." Journal of Neurosurgery, vol. 107, no. 3, 2007, pp. 543-7.
Heckmann JG, Faschingbauer F, Lang C, et al. Laser scanning tomography measurement of the extent of papilledema in the follow-up examination of patients with idiopathic intracranial hypertension. J Neurosurg. 2007;107(3):543-7.
Heckmann, J. G., Faschingbauer, F., Lang, C., Reulbach, U., Dütsch, M., Mardin, C. Y., & Schwab, S. (2007). Laser scanning tomography measurement of the extent of papilledema in the follow-up examination of patients with idiopathic intracranial hypertension. Journal of Neurosurgery, 107(3), 543-7.
Heckmann JG, et al. Laser Scanning Tomography Measurement of the Extent of Papilledema in the Follow-up Examination of Patients With Idiopathic Intracranial Hypertension. J Neurosurg. 2007;107(3):543-7. PubMed PMID: 17886553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laser scanning tomography measurement of the extent of papilledema in the follow-up examination of patients with idiopathic intracranial hypertension. AU - Heckmann,Josef G, AU - Faschingbauer,Florian, AU - Lang,Christoph, AU - Reulbach,Udo, AU - Dütsch,Matthias, AU - Mardin,Christian Y, AU - Schwab,Stefan, PY - 2007/9/25/pubmed PY - 2007/10/12/medline PY - 2007/9/25/entrez SP - 543 EP - 7 JF - Journal of neurosurgery JO - J Neurosurg VL - 107 IS - 3 N2 - OBJECT: The authors evaluated the characteristics of patients with idiopathic intracranial hypertension (IIH), and compared laser scanning tomography (LST) measurements of papilledema with the clinical parameters and cerebrospinal fluid (CSF) opening pressures obtained. METHODS: Twenty-four patients were included in this study; these individuals included 21 women and three men with a mean age of 35.5 +/- 9.7 years and a mean body mass index (BMI) of 35.4 +/- 8.3 kg/m2. The authors conducted a prospective follow-up study over a period of 12 months through a series of four consultations with each patient. These patients had a mean time to treatment of 6.2 +/- 7.9 months and, at the time of diagnosis, suffered a mean of 2.8 +/- 1.3 symptoms each. Laser scanning tomography of the optic disc revealed a mean global rim volume of 1.693 +/- 1.662 mm3 and a mean height of 0.604 +/- 0.306 mm. The mean CSF opening pressure was 31.3 +/- 6.3 cm H2O. RESULTS: During the follow-up period, all patients improved significantly with regard to clinical parameters (p < 0.001), BMI reduction (p < 0.001), and reduction of visual field deficits (p = 0.007); visual acuity remained unchanged. In all patients at each successive consultation, the CSF opening pressure was lower than it had been at the previous consultation (p = 0.001). Laser scanning tomography measurements demonstrated a statistically significant reduction in both optic disc parameters over the follow-up period (global rim volume, p = 0.044; mean height, p = 0.019). The CSF opening pressure and the LST measurements correlated significantly with the number of symptoms (CSF opening pressure, p < 0.001; global rim volume, p = 0.001; mean height, p < 0.001). The mean area under the receiver operating characteristic curve in detecting the presence of clinical symptoms was 0.87 for CSF opening pressure, 0.7 for rim volume, and 0.81 for mean optic disc height. CONCLUSIONS: Laser scanning tomography measurements are useful for evaluating the degree of papilledema in patients with IIH and correspond well with clinical data and measurements of CSF opening pressure. If a diagnosis of IIH is established, LST measurements may replace repeated CSF opening pressure measurements in follow-up monitoring. SN - 0022-3085 UR - https://www.unboundmedicine.com/medline/citation/17886553/Laser_scanning_tomography_measurement_of_the_extent_of_papilledema_in_the_follow_up_examination_of_patients_with_idiopathic_intracranial_hypertension_ L2 - https://thejns.org/doi/10.3171/JNS-07/09/0543 DB - PRIME DP - Unbound Medicine ER -