Non-invasive Estimation of Pulsatile and Static Intracranial Pressure by Optical Coherence Tomography

Abstract

This study examined whether optical coherence tomography (OCT) can be used to estimate the pulsatile and static intracranial pressure (ICP) in patients with idiopathic intracranial hypertension (IIH). Continuous overnight monitoring of the pulsatile and static ICP and a single OCT examination were performed in 20 patients with IIH and in 12 reference subjects without cerebrospinal fluid disturbances. The ICP measurements were obtained using a parenchymal sensor. The pulsatile ICP was determined as the mean ICP wave amplitude (MWA) and the static ICP was determined as the mean ICP. The IIH group had increased overnight MWA and mean ICP scores, and OCT demonstrated anterior deflection of the peripapillary Bruch’s membrane angle (pBA) and increased optic nerve head height (ONHH). There was a significant positive correlation between the pBA and ONHH and the overnight MWA scores, and between mean ICP and ONHH. The pBA and the ONHH also predicted abnormal overnight MWA, but the predictive power of mean ICP was non-significant after adjusting for age and body mass index. This study suggest that the OCT parameters pBA and ONHH can predict abnormal MWA scores.