Detection of mild papilloedema using spectral domain optical coherence tomography

C, Vardanian Vartin; Nguyen, Audrey; Balmitgere, T.; Bernard, Martine; Tilikete, Caroline; Vighetto, Alain

doi:10.1136/bjo.2010.199562

Cited by 66 publications

(50 citation statements)

References 18 publications

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“…At present, no single method has prevailed, so further research is required in order to find and optimize a noninvasive method of measuring ICP that is reliable, easy to use, and cost-effective. [62] ▪ No comparison to invasively measured ICP ▪ OCT parameter peripapillary total retinal thickness (PTR) is a sensitive indicator of mild papilledema Ahuja et al [63] ▪ No comparison to invasively measured ICP ▪ Positive correlation between Frisen grading of papilledema and OCT parameter retinal nerve fiber layer (RNFL) thickness with r = 0.80…”

Section: Resultsmentioning

confidence: 98%

“…The correlation between OCT and Frisen grading for papilledema has been demonstrated in several studies [62][63][64]. One study found a positive correlation between Frisen grading and RNFL thickness with r = 0.7952 [63].…”

Section: Optical Coherence Tomography (Oct)mentioning

confidence: 93%

“…One study found a positive correlation between Frisen grading and RNFL thickness with r = 0.7952 [63]. Taking it one step further, Vartin et al looked at both RNFL thickness and peripapillary total retinal thickness (TRT) and concluded that TRT is a more sensitive indicator for mild papilledema [62]. Meanwhile, Scott et al found that in 36 patients with papilledema, both RNFL thickness and TRT correlated well with Frisen scores with r = 0.85 and r = 0.87, respectively.…”

Section: Optical Coherence Tomography (Oct)mentioning

confidence: 96%

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Noninvasive methods of detecting increased intracranial pressure

Gerety

Alemán

et al. 2016

Childs Nerv Syst

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The detection of elevated intracranial pressure (ICP) is of paramount importance in the diagnosis and management of a number of neurologic pathologies. The current gold standard is the use of intraventricular or intraparenchymal catheters; however, this is invasive, expensive, and requires anesthesia. On the other hand, diagnosing intracranial hypertension based on clinical symptoms such as headaches, vomiting, and visual changes lacks sensitivity. As such, there exists a need for a noninvasive yet accurate and reliable method for detecting elevated ICP. In this review, we aim to cover both structural modalities such as computed tomography (CT), magnetic resonance imaging (MRI), ocular ultrasound, fundoscopy, and optical coherence tomography (OCT) as well as functional modalities such as transcranial Doppler ultrasound (TCD), visual evoked potentials (VEPs), and near-infrared spectroscopy (NIRS).

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Section: Resultsmentioning

confidence: 98%

Section: Optical Coherence Tomography (Oct)mentioning

confidence: 93%

Section: Optical Coherence Tomography (Oct)mentioning

confidence: 96%

See 1 more Smart Citation

Noninvasive methods of detecting increased intracranial pressure

Gerety

Alemán

et al. 2016

Childs Nerv Syst

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“…9) measures as described are found to have better sensitivity for detecting disc edema when compared with circumpapillary RNFL measures. [31][32][33] …”

Section: Circumpapillary Retinal Nerve Fiber Layer Analysismentioning

confidence: 99%

“…Subsequently, total retinal thickness measured at the ONH is found to be sensitive in detecting subclinical changes. [31][32][33] When disc edema is secondary to elevated ICP, quantitative or qualitative assessment of the retinal pigment epithelium angle can be used to assess changes to treatment. 11,47 Specifically, as ICP decreases, there is downward shift in the optic nerve head when compared with the circumpapillary tissue.…”

Section: Increased Retinal Nerve Fiber Layermentioning

confidence: 99%

Optical Coherence Tomography for the Radiologist

Schiffman

Patel

Cruz

et al. 2015

Neuroimaging Clinics of North America

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Evaluation of Optical Coherence Tomography to Detect Elevated Intracranial Pressure in Children

et al. 2017

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IMPORTANCE Detecting elevated intracranial pressure in children with subacute conditions, such as craniosynostosis or tumor, may enable timely intervention and prevent neurocognitive impairment, but conventional techniques are invasive and often equivocal. Elevated intracranial pressure leads to structural changes in the peripapillary retina. Spectral-domain (SD) optical coherence tomography (OCT) can noninvasively quantify retinal layers to a micron-level resolution.OBJECTIVE To evaluate whether retinal measurements from OCT can serve as an effective surrogate for invasive intracranial pressure measurement. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study included patients undergoing procedures at the Children's Hospital of Philadelphia from September 2014 to June 2015. Three groups of patients (n = 79) were prospectively enrolled from the Craniofacial Surgery clinic including patients with craniosynostosis (n = 40). The positive control cohort consisted of patients with hydrocephalus and suspected intracranial hypertension (n = 5), and the negative control cohort consisted of otherwise healthy patients undergoing a minor procedure (n = 34).MAIN OUTCOMES AND MEASURES Spectral-domain OCT was performed preoperatively in all cohorts. Children with cranial pathology, but not negative control patients, underwent direct intraoperative intracranial pressure measurement. The primary outcome was the association between peripapillary retinal OCT parameters and directly measured elevated intracranial pressure. RESULTSThe mean (SD) age was 34.6 (45.2) months in the craniosynostosis cohort (33% female), 48.9 (83.8) months in the hydrocephalus and suspected intracranial hypertension cohort (60% female), and 59.7 (64.4) months in the healthy cohort (47% female). Intracranial pressure correlated with maximal retinal nerve fiber layer thickness (r = 0.60, P Յ .001), maximal retinal thickness (r = 0.53, P Յ .001), and maximal anterior retinal projection (r = 0.53, P = .003). Using cut points derived from the negative control patients, OCT parameters yielded 89% sensitivity (95% CI, 69%-97%) and 62% specificity (95% CI, 41%-79%) for detecting elevated intracranial pressure. The SD-OCT measures had high intereye agreement (intraclass correlation, 0.83-0.93) and high intragrader and intergrader agreement (intraclass correlation Ն0.94). Conventional clinical signs had low sensitivity (11%-42%) for detecting intracranial hypertension.CONCLUSIONS AND RELEVANCE Noninvasive quantitative measures of the peripapillary retinal structure by SD-OCT were correlated with invasively measured intracranial pressure. Optical coherence tomographic parameters showed promise as surrogate, noninvasive measures of intracranial pressure, outperforming other conventional clinical measures. Spectral-domain OCT of the peripapillary region has the potential to advance current treatment paradigms for elevated intracranial pressure in children.

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Detection of mild papilloedema using spectral domain optical coherence tomography

Abstract: PTR thickness measurement increases the sensitivity of detection of mild PO compared with conventional RNFL measurement. This new way of using OCT may be useful for clinicians to detect mild PO.

Cited by 66 publications

References 18 publications

Noninvasive methods of detecting increased intracranial pressure

Noninvasive methods of detecting increased intracranial pressure

Optical Coherence Tomography for the Radiologist

Evaluation of Optical Coherence Tomography to Detect Elevated Intracranial Pressure in Children

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