198002

Correlation between Automated Perimetry and Optical Coherence Tomography in Post Treatment Follow-up of Papilledema due to Idiopathic Intracranial Hypertension

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Last updated: 05 Jan 2025

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Abstract

Objective: To assess correlation between functional changes of the optic nerve evaluated with automated perimetry (AP) and morphological changes of retinal nerve fiber layer (RNFL) evaluated with optical coherence tomography (OCT) in post treatment follow-up of papilledema due to idiopathic intracranial hypertension (IIH).  Methods: We prospectively reviewed 40 eyes (20 patients) having recently diagnosed first attack of IIH with papilledema. Frisén grade of papilledema, Perimetric mean deviation (PMD) and spectral domain optical coherence tomography (SD-OCT) measurement of peripapillary retinal nerve fiber layer (RNFL) thickness were recorded at presentation and at 1st ,3rd and 6th months after starting treatment. We excluded patients with papilledema due to causes other than IIH or glaucoma, and patients who were unwilling to give consent. Results: Our study included 20 patients (40 eyes). Age of patients ranged from 13 to 39 years (mean 27.55±8.4 years). Significant improvement of Frisén grade of papilledema was found throughout the study (p < 0.0001). No patients in the study showed worsening of papilledema grade through the follow up period. There was a significant improvement (p < 0.001) of the retinal nerve fiber layer (RNFL) thickness through the follow up in all patients. At presentation, the median papilledema grade was 2 (range 2-3), which dropped gradually through the study to reach a median of 1 (range 0-1) at the last visit. The mean PMD at presentation was -2.05 ±7.25 dB, improved gradually to reach a mean of -0.59 ±4.02 dB at the last visit. RNFL thickness was (176.7±89µ) at presentation, declined significantly (p < 0.001) to 131.16±25.50 then 121.57±14.20µ then 120.3±14.7µ at 1st, 3rd and 6th month respectively. There was a significant correlation between PMD and RNFL thickness at the last visit (p=0.04). There was also a significant correlation (p < 0.013) between Frisén grade of papilledema and RNFL thickness at all visits. We found that the correlation between papilledema grade and RNFL thickness (r=0.590) was stronger than the correlation between papilledema grade and PMD (r=-0.205) as shown by the correlation coefficient (r). We found no correlation between any of patient's age, laterality of the eye, oral contraceptive pills (OCP) intake or body mass index (BMI) and any of the study findings including best corrected visual acuity (BCVA), Frisén grade of papilledema, PMD or RNFL thickness. Conclusion: Our study showed a significant correlation between RNFL thickness and PMD at the end-of-study visit. Post treatment improvement of RNFL thickness was paralleled by recovery in PMD. As shown by the correlation coefficient (r), we found that the correlation between papilledema grade and RNFL thickness (r=0.590) was stronger than the correlation between papilledema grade and PMD (r=-0.205).

DOI

10.21608/bjas.2021.198002

Authors

First Name

A.S.

Last Name

Beheiry

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Affiliation

Ophthalmologist, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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First Name

M.N.

Last Name

El-Mohamady

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Affiliation

Ophthalmologist, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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First Name

A.M.

Last Name

Saeed

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Affiliation

Ophthalmologist, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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First Name

T.M.

Last Name

Zaghloul

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Ophthalmologist, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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Volume

6

Article Issue

4

Related Issue

27157

Issue Date

2021-08-01

Receive Date

2021-10-04

Publish Date

2021-08-01

Page Start

311

Page End

330

Print ISSN

2356-9751

Online ISSN

2356-976X

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https://bjas.journals.ekb.eg/article_198002.html

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https://bjas.journals.ekb.eg/service?article_code=198002

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48

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Original Research Papers

Type Code

1,647

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Publication Title

Benha Journal of Applied Sciences

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https://bjas.journals.ekb.eg/

MainTitle

Correlation between Automated Perimetry and Optical Coherence Tomography in Post Treatment Follow-up of Papilledema due to Idiopathic Intracranial Hypertension

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Article

Created At

23 Jan 2023