title: Quantification of peripapillary total retinal volume in pseudopapilledema and mild papilledema using spectral-domain optical coherence tomography.
abstract: OBJECTIVE
  To distinguish differences in retinal nerve fiber layer (RNFL) thickness and peripapillary total retinal volume between eyes with papilledema, pseudopapilledema, and normal findings.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Forty-two eyes with mild papilledema, 37 eyes with congenitally elevated optic disc (pseudopapilledema), and 34 normal eyes met the inclusion criteria at 1 academic institution (in Iran) and underwent neuro-ophthalmic examination. Spectral-domain optical coherence tomography scans surrounding the optic disc were performed in each eye of patients and subjects. Main outcome measures were mean RNFL thickness and peripapillary total retinal volume measurements (inner and outer ring volumes) that were compared between groups, using the generalized estimating equation approach. Area under receiver operating characteristic curves were also calculated.
  
  
  RESULTS
  A statistically significant difference was found in mean RNFL thickness between both groups of patients with papilledema and pseudopapilledema and normal subjects. Average inner peripapillary total retinal volume in the papilledema, pseudopapilledema, and control groups were 1.95 ± 0.24 mm(3), 1.81 ± 0.23 mm(3), and 1.06 ± 0.10 mm(3), respectively. Average outer peripapillary total retinal volume in the papilledema and pseudopapilledema groups were 2.68 ± 0.49 mm(3) and 2.03 ± 0.24 mm(3), respectively (P < .001). However, the outer ring peripapillary total retinal volume was not different between pseudopapilledema and normal (1.90 ± 0.11 mm(3)) eyes (P = .17). Area under the curve to discriminate pseudopapilledema vs papilledema eyes for average RNFL thickness and inner and outer peripapillary total retinal volumes was 0.82, 0.68, and 0.88, respectively.
  
  
  CONCLUSIONS
  Outer peripapillary total retinal ring volumes might be useful in differentiating papilledema from pseudopapilledema.
authors.affiliation: Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoud Aghsaei
authors.initials: MA
authors.lastname: Fard
authors.affiliation: Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Fakhree
authors.affiliation: Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Abdi
authors.affiliation: Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Hassanpoor
authors.affiliation: Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: psubram1@jhmi.edu.
authors.forename: Prem S
authors.initials: PS
authors.lastname: Subramanian
mesh_terms: D019540:Area Under Curve; D015331:Cohort Studies; D015785:Eye Diseases, Hereditary / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D010211:Papilledema / Q000175:diagnosis*; D012372:ROC Curve; D012160:Retina / Q000473:pathology*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology