Optic Nerve Head and Macular Optical Coherence Tomography Measurements in Papilledema Compared With Pseudopapilledema

J Neuroophthalmol. 2019 Mar;39(1):28-34. doi: 10.1097/WNO.0000000000000641.

Abstract

Background: To compare macular and optic nerve head optical coherence tomography (OCT) measurements in mild to moderate papilledema and pseudopapilledema.

Methods: One hundred nineteen eyes of 61 patients with mild to moderate papilledema, 84 eyes of 48 patients with pseudopapilledema, and 60 eyes of 60 healthy normal individuals were enrolled in this cross-sectional study. Using Spectralis SD-OCT, macular scans with macular ganglion cell-inner plexiform layer (GCIPL) and macular retinal nerve fiber layer (RNFL) segmentation were performed and divided into 2 regions (inner and outer, with a diameter of 3 and 6 mm, respectively); in addition, Bruch membrane opening (BMO) area and peripapillary RNFL thickness were obtained.

Results: BMO area was similar in papilledema (1.83 ± 0.34 mm), pseudopapilledema (1.85 ± 0.37 mm), and controls (1.85 ± 0.32 mm). Average inner region macular GCIPL thickness in the papilledema, pseudopapilledema, and control groups was 87.2 ± 14.4 μm, 90.8 ± 6.1 μm, and 91.2 ± 9.8 μm, respectively (P > 0.05). Outer temporal region macular GCIPL was significantly thinner in the papilledema group compared with control group (P = 0.01). By contrast, outer inferior and outer nasal macular RNFL sectors were significantly thicker in the papilledema group compared with control groups (P = 0.01 and P < 0.01, respectively). Those measures were not different between pseudopapilledema and control eyes.

Conclusions: In papilledema eyes, outer temporal region macular GCIPL thickness decreased and outer inferior and outer nasal macular RNFL sectors thickness increased compared with the control group. These changes were not observed in the pseudopapilledema group.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Eye Diseases, Hereditary / diagnosis*
  • Eye Diseases, Hereditary / physiopathology
  • Female
  • Humans
  • Macula Lutea / pathology*
  • Male
  • Nerve Fibers / pathology
  • Optic Disk / pathology*
  • Optic Nerve Diseases / diagnosis*
  • Optic Nerve Diseases / physiopathology
  • Papilledema / diagnosis*
  • Papilledema / physiopathology
  • Retinal Ganglion Cells / pathology*
  • Tomography, Optical Coherence / methods*
  • Visual Fields*

Supplementary concepts

  • Pseudopapilledema