title: Use of Ocular Coherence Tomography in Children With Idiopathic Intracranial Hypertension-A Single-Center Experience.
abstract: Idiopathic intracranial hypertension is a disorder characterized by elevated intracranial pressure without an identifiable etiology. Detection of papilledema may be challenging and leads to diagnostic uncertainty in evaluating a child for possible idiopathic intracranial hypertension. Ocular coherence tomography has the potential to add accuracy to the diagnosis of idiopathic intracranial hypertension. The goal of the present study was to determine if there was a relationship between severity of papilledema (as determined by direct ophthalmoscopy and confirmed by fundus photography) and measures of ocular coherence tomography in a pediatric population with idiopathic intracranial hypertension.
  
  
  
  Thirteen pediatric patients were recruited prospectively after diagnosis of either definitive idiopathic intracranial hypertension (with papilledema) or possible idiopathic intracranial hypertension (without papilledema) at Children's Hospital of Michigan over a period of one year. Clinical data and results of initial ocular coherence tomography and visual field testing were collected and statistically analyzed.
  
  
  
  The Frisén scale of papilledema significantly correlated with average retinal nerve fiber layer thickness of each eye (r = 0.633, P = 0.02 in right eye and r = 0.868, P = 0.001 in left eye). The retinal nerve fiber layer thickness (mean ± SD) was significantly higher in the definitive group than in the possible group (189 ± 65 μm vs 104 ± 10 μm in right eye, 165 ± 42 μm vs 106 ± 9 μm in left eye, P < 0.01 in both eyes).
  
  
  
  Ocular coherence tomography may be used as a supplementary method to aid in the reliable detection of papilledema in evaluating a child for idiopathic intracranial hypertension.
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan.
authors.forename: Young Ah
authors.initials: YA
authors.lastname: Lee
authors.affiliation: Wayne State University School of Medicine, Kresge Eye Institute, Detroit, Michigan.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Tomsak
authors.affiliation: Ophthalmic Photography Department, Kresge Eye Institute, Detroit, Michigan.
authors.forename: Zlatan
authors.initials: Z
authors.lastname: Sadikovic
authors.affiliation: Department of Ophthalmology, Wayne State University School of Medicine, Kresge Eye Institute, Detroit, Michigan.
authors.forename: Reecha
authors.initials: R
authors.lastname: Bahl
authors.affiliation: Wayne State University School of Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan. Electronic address: lsivaswamy@med.wayne.edu.
authors.forename: Lalitha
authors.initials: L
authors.lastname: Sivaswamy
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D009900:Optic Nerve / Q000000981:diagnostic imaging; D009929:Organ Size; D010211:Papilledema / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D010865:Pilot Projects; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests
keywords: fundus; idiopathic intracranial hypertension; ocular coherence tomography; papilledema