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Optical coherence tomography represents a sensitive and reliable tool for routine monitoring of idiopathic intracranial hypertension with and without papilledema
Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Neurology. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Neurology.
Southern Med Univ, Peoples R China.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
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2019 (English)In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 26, no 5, p. 808-+Article in journal (Refereed) Published
Abstract [en]

Background and purpose We previously reported that certain optical coherence tomography (OCT) measures were sensitive and reliable in identifying idiopathic intracranial hypertension (IIH). This prospective study aimed to define OCT measures that allow differentiation of IIH with and without papilledema, thereby helping clinical decision-making. Methods Eight patients with IIH with papilledema, nine without papilledema and 19 with other neurological diseases were included. OCT measures were obtained before lumbar puncture and within 2 h, 1, 3 and 6 months after lumbar puncture with cerebrospinal fluid (CSF) removal. Results All patients with papilledema had increased retinal nerve fiber layer (RNFL) thickness and elevated CSF pressure. All patients without papilledema had normal RNFL but elevated CSF pressure. After CSF removal, reduced RNFL thickness was registered in all eight patients with IIH with papilledema. No significant change in RNFL thickness after CSF removal was observed in IIH without papilledema or in patients with other neurological diseases, although reduced CSF pressure was documented. RNFL thickness tended to be normal in patients with IIH with papilledema at 3-6 months after CSF removal. All patients with IIH showed increased rim area and rim thickness, but reduced optic cup volume regardless of RNFL thickness or papilledema. Conclusions Retinal nerve fiber layer thickness is sensitive for monitoring acute IIH and evaluating treatment effect. Increased rim area and rim thickness and decreased optic cup volume are reliable parameters that indicate persistently increased CSF pressure and risk of relapse. OCT measures are sensitive and reliable for diagnosing subtle IIH even in the absence of papilledema.

Place, publisher, year, edition, pages
WILEY , 2019. Vol. 26, no 5, p. 808-+
Keywords [en]
cerebrospinal fluid pressure; cerebrospinal fluid removal; idiopathic intracranial hypertension; lumbar puncture; optical coherence tomography; papilledema
National Category
Neurology
Identifiers
URN: urn:nbn:se:liu:diva-156905DOI: 10.1111/ene.13893ISI: 000466439300021PubMedID: 30586220OAI: oai:DiVA.org:liu-156905DiVA, id: diva2:1318775
Note

Funding Agencies|Faculty of Medicine and Health Sciences at Linkoping University; County Council of Ostergotland; Linkoping University Hospital

Available from: 2019-05-28 Created: 2019-05-28 Last updated: 2019-06-03

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Huang-Link, YuMin

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Huang-Link, YuMinEleftheriou, AndreasJohansson, J. M.Apostolou, Alexandros
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Faculty of Medicine and Health SciencesDepartment of NeurologyDivision of Neuro and Inflammation ScienceDepartment of Clinical and Experimental MedicineDepartment of Ophthalmology in Linköping
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