OCT characteristics in Idiopahthic Intracranial Hypertension Michael Waisbourd
OCT characteristics in Idiopahthic Intracranial Hypertension Michael Waisbourd, MD Igal Leibovitch, MD Dafna Goldenberg, MD Anat Kesler, MD Department of Ophthalmology Tel Aviv Medical Center
Objective • To demonstrate the OCT characteristics in patients with IIH
Materials and Methods • Retrospective review of medical records and OCT images of IIH patients (2006 -2008) • Inclusion – Modified Dandy Criteria – Signs and symptoms of increased ICP – Normal neurologic examination with no localizing signs, except for CN VI palsy – Normal neuroimaging – Normal CSF chemistry and cytology with elevated opening pressure
Results • • 48 IIH patients (46 F, 2 M) Mean age 31 y (13 y-64 y) Mean BMI 31 Kgm 2 Mean LP 326 mm. H 2 O
Results • Visual Acuity – 20/20 to 20/25 - 91. 6% – 20/30 to 20/40 - 4. 2% – 20/50 to 20/100 1. 0% – 20/120 to 20/400 -1. 0% – CF - 1. 0% – NLP - 1. 0% • Automated visual field – Normal 68. 8% – Nasal defect 17. 7% – Mild constriction 2. 1% – Temporal defect 1. 0% – Severe constriction 1. 0% – Data missing 9. 4%
Results • Peripapillary retinal nerve fiber layer (RNFL) was measured for each group by OCT Normal Papilledema
Results – average RNFL P=0. 004
Normal mild elevation Moderate elevation Papilledema (N=20) (N=51) (N=20) P Value Mean 95% CI Nasal 68 (58 – 79) 84 (76 – 93) 98 (82 – 118) 0. 007 Inferior 117 (102 – 134) 146 (134 – 159) 184 (158 – 214) <0. 001 Temporal 62 (54 – 70) 75 (70 – 80) 97 (80 – 117) <0. 001 Superior 103 (92 – 116) 122 (109 – 137) 140 (116 – 170) 0. 043
Conclusion • OCT may assist in evaluating the optic nerve in IIH patients • Prospective follow up of IIH patients by OCT is being investigated in a sequential study
Thank You
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