Optical coherence tomography in papilledema and pseudopapilledema with and without optic nerve head drusen.
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Date
2014-12
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Abstract
Aim: To compare the spectral domain optical coherence tomography (SD-OCT) findings of the optic
disc and the peripapillary retina of patients with a true papilledema and pseudopapilledema with
and without optic nerve head drusen (ONHD). Study Design: Retrospective Case Control Study.
Subjects and Methods: Peripapillary retinal nerve fiber layer (PPRNFL) thickness as depicted by SD-OCT of
94 eyes of 66 patients with papilledema (30 eyes), pseudopapiledema (31 eyes), and normal controls (33 eyes)
was analyzed. The mean RNFL thickness, total retinal thickness (TRT) at a superior and inferior edge of the
disc and the quadrant wise topography of increased RNFL were compared in all three groups. Sensitivity,
specificity, and area under the receiver operating characteristic curve (AROC) were calculated for all the
parameters. Results: The median RNFL thickness was 185.4 (129.5–349.3 μm), 122.3 (109–156.3 μm) and
91.62 ± 7 μm in papilledema, pseudopapilledema, and controls, respectively. Papilledema group had thicker
PPRNFL in all quadrants except temporal quadrant. TRT was thicker in papilledema and pseudopapilledema
compared to controls. ONHD could be directly visualized as high reflective clumps in the sub-retinal space
or the RNFL in 30 eyes. Increased RNFL thickness in all four quadrants was noted 43.3% in papilledema and
9.7% in pseudopapilledema. Normal RNFL thickness in all four quadrants was noted in 0% in papilledema
and 32.3% in pseudopapilledema. Nasal RNFL had the highest AROC (0.792) indicating high diagnostic
ability to differentiate papilledema from pseudopapilledema. Conclusion: SD-OCT can be used as a tool to
differentiate between papilledema and pseudopapilledema.
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Keywords
Optic nerve head drusen, optical coherence tomography, papilledema, pseudopapilloedema
Citation
Bassi Shikha Talwar, Mohana Kuppuswamy Parthasarthy. Optical coherence tomography in papilledema and pseudopapilledema with and without optic nerve head drusen. Indian Journal of Ophthalmology. 2014 Dec ; 62 (12): 1146-1151.