Objective: to evaluate the possible role of optical coherence tomography in assessing different degrees of papilledema by measuring the thickness of the retinal nerve fiber layer.
Patients and methods: Aswan University Hospital's departments of ophthalmology and neurosurgery collaborated on a prospective cohort research (diagnostic study), including 40 patients with (papilledema) in 80 eyes. Researchers gathered data over fifteen months, from October 2020 to December 2021.
Result: The mean Optical coherence tomography- nerve fiber layer (OCT_NFL) for the superior quadrant was 143.9 ± 57.4 with a median of 136 (55 - 340). Also, the OCT_NFL for the inferior quadrant ranged between 28 and 417, with a median of 137 and a mean of 164.7 ± 110.6. Meanwhile, the average OCT_NFL for the nasal quadrant was 113.5 ± 478.9, with a median of 89 (39 - 430). Further, the median OCT_NFL for the temporal quadrant was 73 (34 - 258) and a mean of 83.9 ± 41.8. Respecting the severity of papilledema, about one-third of the eyes had mild (n = 27), 60% (n = 48) moderate, and 6.3% (n = 5) had severe papilledema.
Conclusion: the OCT can be used to identify cases of severe papilledema (mild and moderate) with high confidence based on the thickness of the NFL. However, it can't statistically differentiate between mild and moderate grades of the Frisén scale, but there was a clinically significant difference between mild and moderate when it was used alone or in correlation with OCT findings.