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Correlation between papilledema grade and diffusion-weighted magnetic resonance imaging in idiopathic intracranial hypertension.
J Neuroophthalmol. 2014 Dec; 34(4):331-5.JN

Abstract

BACKGROUND

To explore the relationship between diffusion-weighted magnetic resonance imaging (DWI) hyperintensity of the optic nerve head (ONH) and papilledema grade in patients with idiopathic intracranial hypertension (IIH).

METHODS

A retrospective chart review was conducted of patients with definitively diagnosed IIH by clinical examination and visual field (VF) analysis who underwent orbital magnetic resonance imaging (MRI) within 4 weeks of diagnosis. A neuroradiologist masked to the diagnosis assessed the results of DWI for each eye independently and graded the signal intensity of the ONH into none, mild, and prominent categories. DWI grading was compared with papilledema grade and visual field mean deviation (VFMD) by Spearman rank correlation analysis and t-tests.

RESULTS

Forty-two patients were included in the study. A statistically significant difference (P = 0.0195) was found between papilledema grade and patients with prominent DWI findings (n = 16; mean papilledema grade 3.75 ± 1.25) vs mild or no ONH hyperintensity (n = 26; mean papilledema grade 2.79 ± 1.24) at the time of initial diagnosis. DWI hyperintensity of the ONH at diagnosis was also found to be significantly correlated with the degree of papilledema at follow-up (ρ = 0.39, P = 0.0183) but not with VFMD.

CONCLUSIONS

We found a significant correlation between the severity of papilledema and ONH hyperintensity on DWI in patients with IIH but not with VF loss or other visual parameters. These findings may offer insight into the pathophysiology of papilledema in IIH and provide a surrogate marker for the presence and severity of papilledema.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences (DMS, JBH, MOG, GPVS), Washington University, Saint Louis, Missouri; Department of Ophthalmology and Visual Sciences (LVP), Washington University, Saint Louis, Missouri; Department of Radiology (RV, AS), Mallinckrodt Institute of Radiology, Washington University School, Saint Louis, Missouri; and Department of Neurology (GPVS), Washington University, Saint Louis, Missouri.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25000261

Citation

Salvay, David M., et al. "Correlation Between Papilledema Grade and Diffusion-weighted Magnetic Resonance Imaging in Idiopathic Intracranial Hypertension." Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society, vol. 34, no. 4, 2014, pp. 331-5.
Salvay DM, Padhye LV, Huecker JB, et al. Correlation between papilledema grade and diffusion-weighted magnetic resonance imaging in idiopathic intracranial hypertension. J Neuroophthalmol. 2014;34(4):331-5.
Salvay, D. M., Padhye, L. V., Huecker, J. B., Gordon, M. O., Viets, R., Sharma, A., & Van Stavern, G. P. (2014). Correlation between papilledema grade and diffusion-weighted magnetic resonance imaging in idiopathic intracranial hypertension. Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society, 34(4), 331-5. https://doi.org/10.1097/WNO.0000000000000150
Salvay DM, et al. Correlation Between Papilledema Grade and Diffusion-weighted Magnetic Resonance Imaging in Idiopathic Intracranial Hypertension. J Neuroophthalmol. 2014;34(4):331-5. PubMed PMID: 25000261.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation between papilledema grade and diffusion-weighted magnetic resonance imaging in idiopathic intracranial hypertension. AU - Salvay,David M, AU - Padhye,Leena V, AU - Huecker,Julie B, AU - Gordon,Mae O, AU - Viets,Ryan, AU - Sharma,Aseem, AU - Van Stavern,Gregory P, PY - 2014/7/8/entrez PY - 2014/7/8/pubmed PY - 2015/11/13/medline SP - 331 EP - 5 JF - Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society JO - J Neuroophthalmol VL - 34 IS - 4 N2 - BACKGROUND: To explore the relationship between diffusion-weighted magnetic resonance imaging (DWI) hyperintensity of the optic nerve head (ONH) and papilledema grade in patients with idiopathic intracranial hypertension (IIH). METHODS: A retrospective chart review was conducted of patients with definitively diagnosed IIH by clinical examination and visual field (VF) analysis who underwent orbital magnetic resonance imaging (MRI) within 4 weeks of diagnosis. A neuroradiologist masked to the diagnosis assessed the results of DWI for each eye independently and graded the signal intensity of the ONH into none, mild, and prominent categories. DWI grading was compared with papilledema grade and visual field mean deviation (VFMD) by Spearman rank correlation analysis and t-tests. RESULTS: Forty-two patients were included in the study. A statistically significant difference (P = 0.0195) was found between papilledema grade and patients with prominent DWI findings (n = 16; mean papilledema grade 3.75 ± 1.25) vs mild or no ONH hyperintensity (n = 26; mean papilledema grade 2.79 ± 1.24) at the time of initial diagnosis. DWI hyperintensity of the ONH at diagnosis was also found to be significantly correlated with the degree of papilledema at follow-up (ρ = 0.39, P = 0.0183) but not with VFMD. CONCLUSIONS: We found a significant correlation between the severity of papilledema and ONH hyperintensity on DWI in patients with IIH but not with VF loss or other visual parameters. These findings may offer insight into the pathophysiology of papilledema in IIH and provide a surrogate marker for the presence and severity of papilledema. SN - 1536-5166 UR - https://www.unboundmedicine.com/medline/citation/25000261/Correlation_between_papilledema_grade_and_diffusion_weighted_magnetic_resonance_imaging_in_idiopathic_intracranial_hypertension_ L2 - https://doi.org/10.1097/WNO.0000000000000150 DB - PRIME DP - Unbound Medicine ER -