Optical coherence tomography as an adjunctive tool for diagnosing papilledema in young patients.
OBJECTIVE
The authors examined the peripapillary (3.4-mm diameter) retinal nerve fiber layer thickness (RNFL thickness) as depicted by optical coherence tomography (OCT) in young patients with pseudopapilledema or papilledema.


METHODS
In 17 consecutive patients (6 to 20 years old) with bilateral newly diagnosed papilledema or pseudopapilledema, the eye with the thicker mean global RNFL per patient was analyzed. Excluded were patients in whom cerebrospinal fluid opening pressure was between 190 and 250 mm H(2)O ("gray zone"). RNFL thickness was compared in eyes with papilledema and pseudopapilledema using the Mann-Whitney U test.


RESULTS
Papilledema was clinically diagnosed in 9 patients and pseudopapilledema in 6 patients; 2 patients were excluded. Median RNFL thickness in the eyes with papilledema was greater than that of both eyes with pseudopapilledema and controls at all 12 clock hours. In all 9 patients with papilledema, RNFL was thickened contiguously for 8 to 12 clock hours above the upper 95% confidence interval limit of normal.


CONCLUSIONS
The peripapillary RNFL thickness as depicted by OCT was found to be a reliable adjunctive tool in the differentiation of newly diagnosed papilledema and pseudopapilledema in young patients. Larger cohorts are required to confirm these observations and conclusion.
Martinez
Michael R
MR
Division of Ophthalmology, Hillel-Yaffe Medical Center, Hadera, Israel.
Ophir
Avinoam
A
D000293:Adolescent; D002648:Child; D003937:Diagnosis, Differential; D003941:Diagnostic Techniques, Ophthalmological; D015785:Eye Diseases, Hereditary / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology; D010211:Papilledema / Q000175:diagnosis* / Q000209:etiology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult