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The Relationship Between Optic Disc Volume, Area, and Frisén Score in Patients With Idiopathic Intracranial Hypertension.
Am J Ophthalmol. 2018 11; 195:101-109.AJ

Abstract

PURPOSE

To compare measurements of papilledema using fundus photography, optical coherence tomography (OCT), and Frisén score in patients with idiopathic intracranial hypertension (IIH).

DESIGN

Retrospective, noncomparative analysis of randomized controlled trial data.

METHODS

The Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) evaluated weight management and treatment with acetazolamide compared with placebo in patients with IIH and mild visual loss. Among the 126 subjects in the IIHTT OCT substudy, fundus photographs and OCT scans of the optic disc were taken at baseline and at 6 and 12 months after enrollment. Trained readers scored each eye using a modified Frisén scale and measured the area of disc elevation. OCT scans assessed optic nerve head (ONH) volume. Correlations between volume and area were computed for both study and nonstudy eyes.

RESULTS

Disc area and ONH volume were positively correlated at baseline (R2 = 0.77 in study eyes, P < .001). Correlations between area and volume were similar in the treatment groups at baseline, but were weaker in the acetazolamide group compared with the placebo group at 6 months (R2 = 0.25 vs R2 = 0.76 in study eyes) and 12 months (R2 = 0.19 vs R2 = 0.65 in study eyes). At 6 and 12 months after enrollment, there was no consistent relationship between Frisén score, disc area, and ONH volumes in the acetazolamide group.

CONCLUSION

Frisén score fails to reflect the photographic area and OCT volume of papilledema after treatment with acetazolamide. Clinicians should use caution when using the Frisén scale to monitor the effect of treatment on papilledema over time.

Authors+Show Affiliations

University of Rochester School of Medicine & Dentistry, Rochester, New York, USA; Department of Ophthalmology, David & Ilene Flaum Eye Institute, Rochester, New York, USA.University of Rochester School of Medicine & Dentistry, Rochester, New York, USA; Department of Ophthalmology, David & Ilene Flaum Eye Institute, Rochester, New York, USA.University of Rochester School of Medicine & Dentistry, Rochester, New York, USA; Department of Ophthalmology, David & Ilene Flaum Eye Institute, Rochester, New York, USA.University of Rochester School of Medicine & Dentistry, Rochester, New York, USA; Department of Ophthalmology, David & Ilene Flaum Eye Institute, Rochester, New York, USA.University of Rochester School of Medicine & Dentistry, Rochester, New York, USA; Department of Ophthalmology, David & Ilene Flaum Eye Institute, Rochester, New York, USA. Electronic address: Steven_Feldon@URMC.rochester.edu.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, American Recovery and Reinvestment Act
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30081012

Citation

Sheils, Catherine R., et al. "The Relationship Between Optic Disc Volume, Area, and Frisén Score in Patients With Idiopathic Intracranial Hypertension." American Journal of Ophthalmology, vol. 195, 2018, pp. 101-109.
Sheils CR, Fischer WS, Hollar RA, et al. The Relationship Between Optic Disc Volume, Area, and Frisén Score in Patients With Idiopathic Intracranial Hypertension. Am J Ophthalmol. 2018;195:101-109.
Sheils, C. R., Fischer, W. S., Hollar, R. A., Blanchard, L. M., & Feldon, S. E. (2018). The Relationship Between Optic Disc Volume, Area, and Frisén Score in Patients With Idiopathic Intracranial Hypertension. American Journal of Ophthalmology, 195, 101-109. https://doi.org/10.1016/j.ajo.2018.07.032
Sheils CR, et al. The Relationship Between Optic Disc Volume, Area, and Frisén Score in Patients With Idiopathic Intracranial Hypertension. Am J Ophthalmol. 2018;195:101-109. PubMed PMID: 30081012.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Relationship Between Optic Disc Volume, Area, and Frisén Score in Patients With Idiopathic Intracranial Hypertension. AU - Sheils,Catherine R, AU - Fischer,William S, AU - Hollar,Rachel A, AU - Blanchard,Lisa M, AU - Feldon,Steven E, AU - ,, Y1 - 2018/08/04/ PY - 2018/02/06/received PY - 2018/07/23/revised PY - 2018/07/25/accepted PY - 2018/8/7/pubmed PY - 2019/9/4/medline PY - 2018/8/7/entrez SP - 101 EP - 109 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 195 N2 - PURPOSE: To compare measurements of papilledema using fundus photography, optical coherence tomography (OCT), and Frisén score in patients with idiopathic intracranial hypertension (IIH). DESIGN: Retrospective, noncomparative analysis of randomized controlled trial data. METHODS: The Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) evaluated weight management and treatment with acetazolamide compared with placebo in patients with IIH and mild visual loss. Among the 126 subjects in the IIHTT OCT substudy, fundus photographs and OCT scans of the optic disc were taken at baseline and at 6 and 12 months after enrollment. Trained readers scored each eye using a modified Frisén scale and measured the area of disc elevation. OCT scans assessed optic nerve head (ONH) volume. Correlations between volume and area were computed for both study and nonstudy eyes. RESULTS: Disc area and ONH volume were positively correlated at baseline (R2 = 0.77 in study eyes, P < .001). Correlations between area and volume were similar in the treatment groups at baseline, but were weaker in the acetazolamide group compared with the placebo group at 6 months (R2 = 0.25 vs R2 = 0.76 in study eyes) and 12 months (R2 = 0.19 vs R2 = 0.65 in study eyes). At 6 and 12 months after enrollment, there was no consistent relationship between Frisén score, disc area, and ONH volumes in the acetazolamide group. CONCLUSION: Frisén score fails to reflect the photographic area and OCT volume of papilledema after treatment with acetazolamide. Clinicians should use caution when using the Frisén scale to monitor the effect of treatment on papilledema over time. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/30081012/The_Relationship_Between_Optic_Disc_Volume_Area_and_Frisén_Score_in_Patients_With_Idiopathic_Intracranial_Hypertension_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(18)30425-2 DB - PRIME DP - Unbound Medicine ER -