title: Baseline OCT measurements in the idiopathic intracranial hypertension treatment trial, part II: correlations and relationship to clinical features.
abstract: OBJECTIVE
  The accepted method to evaluate and monitor papilledema, Frisén grading, uses an ordinal approach based on descriptive features. Part I showed that spectral-domain optical coherence tomography (SD-OCT) in a clinical trial setting provides reliable measurement of the effects of papilledema on the optic nerve head (ONH) and peripapillary retina, particularly if a 3-D segmentation method is used for analysis.(1) We evaluated how OCT parameters are interrelated and how they correlate with vision and other clinical features in idiopathic intracranial hypertension (IIH) patients.
  
  
  METHODS
  A total of 126 subjects in the IIH Treatment Trial (IIHTT) OCT substudy had Cirrus SD-OCT optic disc and macula scans analyzed by using a 3-D segmentation algorithm to derive retinal nerve fiber layer (RNFL) thickness, total retinal thickness (TRT), retinal ganglion cell layer plus inner plexiform layer (GCL+IPL) thickness, and ONH volume. The SD-OCT parameter values were correlated with high- and low-contrast acuity, perimetric mean deviation, Frisén grading, and IIH features.
  
  
  RESULTS
  At study entry, the average RNFL thickness, TRT, and ONH volume showed significant strong correlations (r ≥ 0.90) with each other. The same OCT parameters showed a strong (r > 0.76) correlation with Frisén grade and a mild (r > 0.24), but significant, correlation with lumbar puncture opening pressure. For all eyes at baseline, neither visual acuity (high or low contrast) nor mean deviation correlated with any OCT measure of swelling or GCL+IPL thickness.
  
  
  CONCLUSIONS
  In newly diagnosed IIH, OCT demonstrated alterations of the peripapillary retina and ONH correlate with Frisén grading of papilledema. At presentation, OCT measures of papilledema, in patients with newly diagnosed IIH and mild vision loss, do not correlate with clinical features or visual dysfunction. (ClinicalTrials.gov number, NCT01003639.).
authors.forename: Peggy
authors.initials: P
authors.lastname: Auinger
authors.forename: Mary
authors.initials: M
authors.lastname: Durbin
authors.forename: Steven
authors.initials: S
authors.lastname: Feldon
authors.forename: Mona
authors.initials: M
authors.lastname: Garvin
authors.forename: Randy
authors.initials: R
authors.lastname: Kardon
authors.forename: John
authors.initials: J
authors.lastname: Keltner
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Kupersmith
authors.forename: Patrick
authors.initials: P
authors.lastname: Sibony
authors.forename: Kim
authors.initials: K
authors.lastname: Plumb
authors.forename: Jui-Kai
authors.initials: JK
authors.lastname: Wang
authors.forename: John S
authors.initials: JS
authors.lastname: Werner
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009898:Optic Disk / Q000473:pathology; D010211:Papilledema / Q000473:pathology*; D012165:Retinal Ganglion Cells / Q000473:pathology; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity; D055815:Young Adult
keywords: OCT; intracranial hypertension; lumbar puncture; papilledema