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Baseline OCT measurements in the idiopathic intracranial hypertension treatment trial, part II: correlations and relationship to clinical features.
Invest Ophthalmol Vis Sci. 2014 Nov 04; 55(12):8173-9.IO

Abstract

PURPOSE

The accepted method to evaluate and monitor papilledema, Frisén grading, uses an ordinal approach based on descriptive features. Part I showed that spectral-domain optical coherence tomography (SD-OCT) in a clinical trial setting provides reliable measurement of the effects of papilledema on the optic nerve head (ONH) and peripapillary retina, particularly if a 3-D segmentation method is used for analysis.(1) We evaluated how OCT parameters are interrelated and how they correlate with vision and other clinical features in idiopathic intracranial hypertension (IIH) patients.

METHODS

A total of 126 subjects in the IIH Treatment Trial (IIHTT) OCT substudy had Cirrus SD-OCT optic disc and macula scans analyzed by using a 3-D segmentation algorithm to derive retinal nerve fiber layer (RNFL) thickness, total retinal thickness (TRT), retinal ganglion cell layer plus inner plexiform layer (GCL+IPL) thickness, and ONH volume. The SD-OCT parameter values were correlated with high- and low-contrast acuity, perimetric mean deviation, Frisén grading, and IIH features.

RESULTS

At study entry, the average RNFL thickness, TRT, and ONH volume showed significant strong correlations (r ≥ 0.90) with each other. The same OCT parameters showed a strong (r > 0.76) correlation with Frisén grade and a mild (r > 0.24), but significant, correlation with lumbar puncture opening pressure. For all eyes at baseline, neither visual acuity (high or low contrast) nor mean deviation correlated with any OCT measure of swelling or GCL+IPL thickness.

CONCLUSIONS

In newly diagnosed IIH, OCT demonstrated alterations of the peripapillary retina and ONH correlate with Frisén grading of papilledema. At presentation, OCT measures of papilledema, in patients with newly diagnosed IIH and mild vision loss, do not correlate with clinical features or visual dysfunction. (ClinicalTrials.gov number, NCT01003639.).

Authors

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Pub Type(s)

Clinical Trial
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25370513

Citation

OCT Sub-Study Committee for NORDIC Idiopathic Intracranial Hypertension Study Group, et al. "Baseline OCT Measurements in the Idiopathic Intracranial Hypertension Treatment Trial, Part II: Correlations and Relationship to Clinical Features." Investigative Ophthalmology & Visual Science, vol. 55, no. 12, 2014, pp. 8173-9.
OCT Sub-Study Committee for NORDIC Idiopathic Intracranial Hypertension Study Group, Auinger P, Durbin M, et al. Baseline OCT measurements in the idiopathic intracranial hypertension treatment trial, part II: correlations and relationship to clinical features. Invest Ophthalmol Vis Sci. 2014;55(12):8173-9.
Auinger, P., Durbin, M., Feldon, S., Garvin, M., Kardon, R., Keltner, J., Kupersmith, M. J., Sibony, P., Plumb, K., Wang, J. K., & Werner, J. S. (2014). Baseline OCT measurements in the idiopathic intracranial hypertension treatment trial, part II: correlations and relationship to clinical features. Investigative Ophthalmology & Visual Science, 55(12), 8173-9. https://doi.org/10.1167/iovs.14-14961
OCT Sub-Study Committee for NORDIC Idiopathic Intracranial Hypertension Study Group, et al. Baseline OCT Measurements in the Idiopathic Intracranial Hypertension Treatment Trial, Part II: Correlations and Relationship to Clinical Features. Invest Ophthalmol Vis Sci. 2014 Nov 4;55(12):8173-9. PubMed PMID: 25370513.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Baseline OCT measurements in the idiopathic intracranial hypertension treatment trial, part II: correlations and relationship to clinical features. AU - ,, AU - Auinger,Peggy, AU - Durbin,Mary, AU - Feldon,Steven, AU - Garvin,Mona, AU - Kardon,Randy, AU - Keltner,John, AU - Kupersmith,Mark J, AU - Sibony,Patrick, AU - Plumb,Kim, AU - Wang,Jui-Kai, AU - Werner,John S, Y1 - 2014/11/04/ PY - 2014/11/6/entrez PY - 2014/11/6/pubmed PY - 2015/3/3/medline KW - OCT KW - intracranial hypertension KW - lumbar puncture KW - papilledema SP - 8173 EP - 9 JF - Investigative ophthalmology & visual science JO - Invest Ophthalmol Vis Sci VL - 55 IS - 12 N2 - PURPOSE: The accepted method to evaluate and monitor papilledema, Frisén grading, uses an ordinal approach based on descriptive features. Part I showed that spectral-domain optical coherence tomography (SD-OCT) in a clinical trial setting provides reliable measurement of the effects of papilledema on the optic nerve head (ONH) and peripapillary retina, particularly if a 3-D segmentation method is used for analysis.(1) We evaluated how OCT parameters are interrelated and how they correlate with vision and other clinical features in idiopathic intracranial hypertension (IIH) patients. METHODS: A total of 126 subjects in the IIH Treatment Trial (IIHTT) OCT substudy had Cirrus SD-OCT optic disc and macula scans analyzed by using a 3-D segmentation algorithm to derive retinal nerve fiber layer (RNFL) thickness, total retinal thickness (TRT), retinal ganglion cell layer plus inner plexiform layer (GCL+IPL) thickness, and ONH volume. The SD-OCT parameter values were correlated with high- and low-contrast acuity, perimetric mean deviation, Frisén grading, and IIH features. RESULTS: At study entry, the average RNFL thickness, TRT, and ONH volume showed significant strong correlations (r ≥ 0.90) with each other. The same OCT parameters showed a strong (r > 0.76) correlation with Frisén grade and a mild (r > 0.24), but significant, correlation with lumbar puncture opening pressure. For all eyes at baseline, neither visual acuity (high or low contrast) nor mean deviation correlated with any OCT measure of swelling or GCL+IPL thickness. CONCLUSIONS: In newly diagnosed IIH, OCT demonstrated alterations of the peripapillary retina and ONH correlate with Frisén grading of papilledema. At presentation, OCT measures of papilledema, in patients with newly diagnosed IIH and mild vision loss, do not correlate with clinical features or visual dysfunction. (ClinicalTrials.gov number, NCT01003639.). SN - 1552-5783 UR - https://www.unboundmedicine.com/medline/citation/25370513/Baseline_OCT_measurements_in_the_idiopathic_intracranial_hypertension_treatment_trial_part_II:_correlations_and_relationship_to_clinical_features_ L2 - https://iovs.arvojournals.org/article.aspx?doi=10.1167/iovs.14-14961 DB - PRIME DP - Unbound Medicine ER -