RESUMEN

Bilateral edematous optic disc swelling from papilledema is caused by elevated intracranial pressure (ICP). Idiopathic intracranial hypertension (IIH), a clinical syndrome with elevated ICP of unclear etiology, is a frequent cause of this condition. IIH typically affects obese middle-aged females. Papilledema usually has a fairly symmetrical bilateral pattern. Unilateral papilledema is a rare disorder that must be detected early to avoid optic nerve damage. However, the etiology of unilateral papilledema remains unclear. Based on bilateral optic nerve sheath diameter measurements, we aimed to find an explanation for the unilaterality in this rare case.

Asunto(s)

Nervio Óptico , Papiledema , Humanos , Papiledema/diagnóstico , Papiledema/etiología , Femenino , Nervio Óptico/patología , Nervio Óptico/diagnóstico por imagen , Disco Óptico , Adulto , Presión Intracraneal , Agudeza Visual , Tomografía de Coherencia Óptica/métodos , Seudotumor Cerebral/diagnóstico , Seudotumor Cerebral/complicaciones , Imagen por Resonancia Magnética

RESUMEN

BACKGROUND: Papilledema is the optic disc swelling caused by increased intracranial pressure (ICP) that can damage the optic nerve and cause subsequent vision loss. Pseudopapilledema refers to optic disc elevation without peripapillary fluid that can arise from several optic disc disorders, with optic disc drusen (ODD) being the most frequent cause. Occasionally, pseudopapilledema patients are mistakenly diagnosed as papilledema, leading to the possibility of unneeded procedures. We aim to thoroughly examine the most current evidence on papilledema and pseudopapilledema causes and several methods for distinguishing between both conditions. METHODS: An extensive literature search was conducted on electronic databases including PubMed and google scholar using keywords that were relevant to the assessed pathologies. Data were collected and then summarized in comprehensive form. RESULTS: Various techniques are employed to distinguish between papilledema and pseudopapilledema. These techniques include Fundus fluorescein angiography, optical coherence tomography, ultrasonography, and magnetic resonance imaging. Lumbar puncture and other invasive procedures may be needed if results are suspicious. CONCLUSION: Papilledema is a sight-threatening condition that may lead to visual affection. Many disc conditions may mimic papilledema. Accordingly, differentiation between papilledema and pseudopailledema is crucial and can be conducted through many modalities.

Asunto(s)

Enfermedades Hereditarias del Ojo , Angiografía con Fluoresceína , Disco Óptico , Papiledema , Tomografía de Coherencia Óptica , Papiledema/diagnóstico , Humanos , Diagnóstico Diferencial , Tomografía de Coherencia Óptica/métodos , Angiografía con Fluoresceína/métodos , Disco Óptico/diagnóstico por imagen , Disco Óptico/patología , Enfermedades Hereditarias del Ojo/diagnóstico , Enfermedades del Nervio Óptico/diagnóstico , Fondo de Ojo , Imagen por Resonancia Magnética/métodos , Drusas del Disco Óptico/diagnóstico , Drusas del Disco Óptico/fisiopatología , Drusas del Disco Óptico/complicaciones

RESUMEN

Purpose: To evaluate subfoveal choroidal thickness (SFCT) in eyes with diabetic macular edema (DME) using spectral domain OCT (SD-OCT). Materials and methods: Ninety eyes were divided into three equal groups: group A, non-proliferative diabetic retinopathy (NPDR) with no DME; group B, NPDR having DME; and group C, non-diabetic patients. The central subfield retinal thickness (CSRT) and SFCT were measured using spectral domain OCT. Results: There was a moderate negative correlation between age and SFCT in group B (r=-0.455, P=0.012). We found no significant correlation between best corrected visual acuity (BCVA) and SFCT in all groups (for groups A, B, and C, respectively: r=0.189, P=0.316; r=-0.195, P=0.302; and r=-0.181, P=0.337). There was no significant correlation between duration of diabetes and SFCT (r=-0.118, P=0.534 and r=-0.136, P=0.475 for groups A and B, respectively). The CSRT was 229.13±16.2, 336.4±74.85, and 223.13±16.9 µm in groups A, B, and C, respectively. The mean SFCT was 260.6±49.2, 259±50.8, and 252±50 µm in groups A, B, and C, respectively. We found no significant correlation between CSRT and SFCT in all groups (for groups A, B, and C, respectively: r=-0.049, P=0.796, r=0.239, P=0.204, r=-0.021, P=0.914). There was no significant difference in SFCT between group B (DME) on one hand and groups A and C on the other hand (P=0.9 and 0.59, respectively). Conclusion: There is no significant correlation between CSRT and SFCT in DME. Choroidal thickness assessment is not an indicator of the severity of DME and cannot be used as a monitor of its progression.