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The Optic Canal Size Is Associated With the Severity of Papilledema and Poor Visual Function in Idiopathic Intracranial Hypertension.
J Neuroophthalmol. 2016 06; 36(2):120-5.JN

Abstract

BACKGROUND

To determine whether the size of the bony optic canal is associated with the severity of papilledema and poor visual function in idiopathic intracranial hypertension (IIH).

METHODS

We performed a retrospective review of definite patients with IIH with requisite brain magnetic resonance imaging allowing for optic canal measurement. Clinical characteristics and automated (Humphrey) visual field results were reviewed; papilledema was graded according to the modified Frisén scale. Cross-sectional area of the optic canals was measured independently by 2 readers and averaged for each canal. Logistic regression modeling was applied.

RESULTS

Sixty-nine patients with IIH were included (mean age: 33; 91% women; 65% black). Controlling for age, sex, body mass index, race, and cerebrospinal fluid (CSF) opening pressure, each mm increase in canal size was associated with a 0.50 dB reduction in Humphrey visual field mean deviation (P = 0.006); this was likely mediated by the increased odds of Grade 4-5 papilledema or optic atrophy in patients with larger canals (odds ratio: 1.30 [95% CI: 1.10-1.55; P = 0.003] for Grade 4-5 papilledema or atrophy vs grade <4 papilledema per mm increase in canal size).

CONCLUSIONS

Poor visual function and severe papilledema or optic atrophy were associated with a larger optic canal. Potential mechanisms include alteration of local CSF flow or bony remodeling at the optic canals.

Authors+Show Affiliations

Departments of Ophthalmology (SB, LC, NJN, VB, BBB), Radiology and Imaging Science (AMS), Neurology (NJN, VB, BBB), and Neurological Surgery (NJN), Emory University School of Medicine, Atlanta, Georgia; and Department of Epidemiology (BBB), Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, Georgia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

26580295

Citation

Bidot, Samuel, et al. "The Optic Canal Size Is Associated With the Severity of Papilledema and Poor Visual Function in Idiopathic Intracranial Hypertension." Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society, vol. 36, no. 2, 2016, pp. 120-5.
Bidot S, Clough L, Saindane AM, et al. The Optic Canal Size Is Associated With the Severity of Papilledema and Poor Visual Function in Idiopathic Intracranial Hypertension. J Neuroophthalmol. 2016;36(2):120-5.
Bidot, S., Clough, L., Saindane, A. M., Newman, N. J., Biousse, V., & Bruce, B. B. (2016). The Optic Canal Size Is Associated With the Severity of Papilledema and Poor Visual Function in Idiopathic Intracranial Hypertension. Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society, 36(2), 120-5. https://doi.org/10.1097/WNO.0000000000000318
Bidot S, et al. The Optic Canal Size Is Associated With the Severity of Papilledema and Poor Visual Function in Idiopathic Intracranial Hypertension. J Neuroophthalmol. 2016;36(2):120-5. PubMed PMID: 26580295.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Optic Canal Size Is Associated With the Severity of Papilledema and Poor Visual Function in Idiopathic Intracranial Hypertension. AU - Bidot,Samuel, AU - Clough,Lindsay, AU - Saindane,Amit M, AU - Newman,Nancy J, AU - Biousse,Valérie, AU - Bruce,Beau B, PY - 2015/11/19/entrez PY - 2015/11/19/pubmed PY - 2017/9/2/medline SP - 120 EP - 5 JF - Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society JO - J Neuroophthalmol VL - 36 IS - 2 N2 - BACKGROUND: To determine whether the size of the bony optic canal is associated with the severity of papilledema and poor visual function in idiopathic intracranial hypertension (IIH). METHODS: We performed a retrospective review of definite patients with IIH with requisite brain magnetic resonance imaging allowing for optic canal measurement. Clinical characteristics and automated (Humphrey) visual field results were reviewed; papilledema was graded according to the modified Frisén scale. Cross-sectional area of the optic canals was measured independently by 2 readers and averaged for each canal. Logistic regression modeling was applied. RESULTS: Sixty-nine patients with IIH were included (mean age: 33; 91% women; 65% black). Controlling for age, sex, body mass index, race, and cerebrospinal fluid (CSF) opening pressure, each mm increase in canal size was associated with a 0.50 dB reduction in Humphrey visual field mean deviation (P = 0.006); this was likely mediated by the increased odds of Grade 4-5 papilledema or optic atrophy in patients with larger canals (odds ratio: 1.30 [95% CI: 1.10-1.55; P = 0.003] for Grade 4-5 papilledema or atrophy vs grade <4 papilledema per mm increase in canal size). CONCLUSIONS: Poor visual function and severe papilledema or optic atrophy were associated with a larger optic canal. Potential mechanisms include alteration of local CSF flow or bony remodeling at the optic canals. SN - 1536-5166 UR - https://www.unboundmedicine.com/medline/citation/26580295/The_Optic_Canal_Size_Is_Associated_With_the_Severity_of_Papilledema_and_Poor_Visual_Function_in_Idiopathic_Intracranial_Hypertension_ L2 - https://doi.org/10.1097/WNO.0000000000000318 DB - PRIME DP - Unbound Medicine ER -