Retinal atrophy in eyes with resolved papilledema detected by optical coherence tomography.
BACKGROUND
To apply automated spectral domain optical coherence tomography (SD-OCT) segmentation to eyes with resolving papilledema.


METHODS
Ninety-four patients with idiopathic intracranial hypertension seen at the Duke Eye Center neuro-ophthalmology clinic between November 2010 and October 2011 were reviewed. Excluded were eyes with papilledema with Frisén grade >2, other optic neuropathies or retinopathies, and those that did not have SD-OCT imaging. The remaining 43 patients were split into 2 groups: non-atrophic papilledema and atrophic papilledema. Automated SD-OCT segmentation was performed on patients with non-atrophic papilledema and age-matched controls for each of the 9 regions of the Early Treatment Diabetic Retinopathy Study map. Bonferroni correction was used for multiple comparisons. All SD-OCT scans were reviewed for retinal structural abnormalities.


RESULTS
Total macular thickness was significantly thinner within the fovea and inner macular ring in non-atrophic papilledema vs control eyes (266 vs 276 μm, P = 0.04; 333 vs 344 μm P < 0.01, n = 26 non-atrophic papilledema, 30 controls). SD-OCT demonstrated thinning within the fovea, inner macular ring, and outer macular ring of the outer plexiform layer plus nuclear layer in non-atrophic papilledema vs control (124 vs 131 μm, P < 0.01; 112 vs 118 μm, P = 0.03; 95 vs 100 μm, P = 0.03). Retinal structural changes were seen in 21/33 eyes with atrophic papilledema vs none of the eyes with non-atrophic papilledema or controls.


CONCLUSIONS
SD-OCT shows qualitative and quantitative changes in the macula of eyes with resolved papilledema.
Departments of Ophthalmology (BEG, MTB, SF, MAE), Neurology (MTB), and Biomedical Engineering (PPS, SJC, SF), Duke University Medical Center, Durham, North Carolina.
Brian E
BE
Goldhagen
M Tariq
MT
Bhatti
Pratul P
PP
Srinivasan
Stephanie J
SJ
Chiu
Sina
S
Farsiu
Mays A
MA
El-Dairi
D000293:Adolescent; D000328:Adult; D001284:Atrophy / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000150:complications* / Q000000981:diagnostic imaging*; D011859:Radiography; D012160:Retina / Q000473:pathology*; D012164:Retinal Diseases / Q000209:etiology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D055815:Young Adult