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OCT measurements of optic nerve head changes in idiopathic intracranial hypertension.
Clin Neurol Neurosurg. 2015 Mar; 130:122-7.CN

Abstract

OBJECTIVE

Severity of papilledema and vision loss constitute a basis for therapeutic intervention in idiopathic intracranial hypertension (IIH), but both are often subjective and insensitive in guiding clinical management. The aim of this study was to identify reliable and sensitive measurements of optic nerve head (ONH) and macula, to provide objective guidance for prognostic evaluation and treatment in IIH. We analyzed potential of spectral domain optical coherence tomography (SD-OCT), to measure neuro-retinal rim thickness and area, optic cup-to-disc ratio (C/D) and cup volume of ONH which have not previously been reported in IIH. In parallel, thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell layer (GCL) together with inner plexiform layer (IPL) (GCL-IPL) were examined.

RESULTS

All 7 enrolled IIH patients had increased neuro-retinal rim thickness (p<0.01 for both eyes) and rim area (p<0.05), decreased C/D (p<0.01) and optic cup volume (p<0.01) when compared to findings in 18 sex- and age-matched healthy controls (HC). In a longitudinal study, two IIH patients were followed repetitively by SD-OCT before and after measurement of intracranial pressure (ICP) and removal of cerebrospinal fluid (CSF) by lumbar puncture. Rim thickness and area, C/D and optic cup volume remained altered. RNFL thickness may change with very high ICP, but not immediately after CSF removal. GCL-IPL thickness was unchanged irrespective of ICP change or CSF removal.

CONCLUSION

SD-OCT allows detection of ONH changes even in subtle IIH without papilledema and has potential for routine use in IIH.

Authors+Show Affiliations

Division of Neurology, Department of Clinical and Experimental Medicine, Linköping University, 581 85 Linköping, Sweden. Electronic address: yumin.link@lio.se.Division of Ophthalmology, Department of Clinical and Experimental Medicine, Linköping University, 581 85 Linköping, Sweden.NeuroCure Clinical Research Center, Charité University Medicine Berlin, Berlin, Germany.Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25614195

Citation

Huang-Link, Yu-Min, et al. "OCT Measurements of Optic Nerve Head Changes in Idiopathic Intracranial Hypertension." Clinical Neurology and Neurosurgery, vol. 130, 2015, pp. 122-7.
Huang-Link YM, Al-Hawasi A, Oberwahrenbrock T, et al. OCT measurements of optic nerve head changes in idiopathic intracranial hypertension. Clin Neurol Neurosurg. 2015;130:122-7.
Huang-Link, Y. M., Al-Hawasi, A., Oberwahrenbrock, T., & Jin, Y. P. (2015). OCT measurements of optic nerve head changes in idiopathic intracranial hypertension. Clinical Neurology and Neurosurgery, 130, 122-7. https://doi.org/10.1016/j.clineuro.2014.12.021
Huang-Link YM, et al. OCT Measurements of Optic Nerve Head Changes in Idiopathic Intracranial Hypertension. Clin Neurol Neurosurg. 2015;130:122-7. PubMed PMID: 25614195.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - OCT measurements of optic nerve head changes in idiopathic intracranial hypertension. AU - Huang-Link,Yu-Min, AU - Al-Hawasi,Abbas, AU - Oberwahrenbrock,Timm, AU - Jin,Ya-Ping, Y1 - 2015/01/07/ PY - 2014/05/25/received PY - 2014/12/15/revised PY - 2014/12/28/accepted PY - 2015/1/24/entrez PY - 2015/1/24/pubmed PY - 2015/11/18/medline KW - Cerebrospinal fluid KW - Idiopathic intracranial hypertension KW - Optic nerve head KW - Optical coherence tomography KW - Papilledema SP - 122 EP - 7 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 130 N2 - OBJECTIVE: Severity of papilledema and vision loss constitute a basis for therapeutic intervention in idiopathic intracranial hypertension (IIH), but both are often subjective and insensitive in guiding clinical management. The aim of this study was to identify reliable and sensitive measurements of optic nerve head (ONH) and macula, to provide objective guidance for prognostic evaluation and treatment in IIH. We analyzed potential of spectral domain optical coherence tomography (SD-OCT), to measure neuro-retinal rim thickness and area, optic cup-to-disc ratio (C/D) and cup volume of ONH which have not previously been reported in IIH. In parallel, thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell layer (GCL) together with inner plexiform layer (IPL) (GCL-IPL) were examined. RESULTS: All 7 enrolled IIH patients had increased neuro-retinal rim thickness (p<0.01 for both eyes) and rim area (p<0.05), decreased C/D (p<0.01) and optic cup volume (p<0.01) when compared to findings in 18 sex- and age-matched healthy controls (HC). In a longitudinal study, two IIH patients were followed repetitively by SD-OCT before and after measurement of intracranial pressure (ICP) and removal of cerebrospinal fluid (CSF) by lumbar puncture. Rim thickness and area, C/D and optic cup volume remained altered. RNFL thickness may change with very high ICP, but not immediately after CSF removal. GCL-IPL thickness was unchanged irrespective of ICP change or CSF removal. CONCLUSION: SD-OCT allows detection of ONH changes even in subtle IIH without papilledema and has potential for routine use in IIH. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/25614195/OCT_measurements_of_optic_nerve_head_changes_in_idiopathic_intracranial_hypertension_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(14)00497-1 DB - PRIME DP - Unbound Medicine ER -