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Role of spectral domain optical coherence tomography in the diagnosis and prognosis of papilledema.
Panyala, Rakesh; Sharma, Pradeep; Sihota, Ramanjit; Saxena, Rohit; Prasad, Kameshwar; Phuljhele, Swati; Gurrala, Sneha; Bhaskaran, Karthika.
Afiliación
  • Panyala R; Consultant Pediatric Ophthalmology and Strabismus, MaxiVision Eye Hospital, Karimnagar, India.
  • Sharma P; Professor Head Strabismus, Pediatric Ophthalmology and Neuro-Ophthalmology, AIIMS; Director Strabismus Pediatric and Neuro-Ophthalmology Centre for Sight, New Delhi, India.
  • Sihota R; Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, India.
  • Saxena R; Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, India.
  • Prasad K; Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, India.
  • Phuljhele S; Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, India.
  • Gurrala S; MBBS, Kamineni Institute of Medical Sciences, Narketpally, Hyderabad, Telangana, India.
  • Bhaskaran K; Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol ; 69(9): 2372-2377, 2021 Sep.
Article en En | MEDLINE | ID: mdl-34427225
PURPOSE: The study of papilledema with a novel noninvasive technique such as spectral domain-optical coherence tomography (SD-OCT) provides minute and detailed cross-sectional changes thus giving an insight into the application of biomechanical principles and pathophysiology of disc edema. METHODS: We measured average retinal nerve fiber layer (RNFL) thickness and the retinal pigment epithelium/Bruch's membrane (RPE/BM) angle at the temporal and nasal borders of the neural canal opening (NCO) in 30 eyes with papilledema, 30 eyes with papillitis, and 80 control eyes. The inward angulation was considered as positive and the outward as negative. Follow-up was done at 1, 2, 3, and 6 months. The main outcome measures are the average RNFL thickness and the RPE/BM angle. RESULTS: 29 eyes (96.6%) with papilledema had a positive RPE/BM angle (+8.11 ± 3.13). 29 eyes (96.6%) with papillitis had a negative RPE/BM angle (-1.04 ± 3.27). On follow-up at 1 month, both RNFL thickness (P = 0.01) and RPE-BM angle (P = 0.001) reduced significantly in eyes with papilledema; in eyes with papillitis, there was a significant reduction in the RNFL thickness (P = 0.02), but not in the RPE-BM angle (P > 0.05). RNFL thickness in papilledema cases normalized at 3 months whereas RPE/BM normalized at 6 months of follow-up. To detect papilledema, OCT has a sensitivity of 96.66% and specificity of 99.09% on both nasal and temporal sides. CONCLUSION: After appropriate treatment, the RPE/BM angle in papilledema decreased much later than the RNFL thickness. Hence, the RPE/BM angle in papilledema (positive) can be used to differentiate it from papillitis (negative) and also to monitor the activity of the disease.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disco Óptico / Papiledema Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Indian J Ophthalmol Año: 2021 Tipo del documento: Article País de afiliación: India Pais de publicación: India
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Disco Óptico / Papiledema Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Indian J Ophthalmol Año: 2021 Tipo del documento: Article País de afiliación: India Pais de publicación: India