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Optical coherence tomography application in diagnostics and monitoring of idiopathic intracranial hypertension patients


Authors: Z. Kasl 1;  Š. Rusňák 1;  T. Ishizaki 1;  M. Krčma 2;  M. Peterka 3;  V. Rohan 3;  J. Dostál 4;  N. Jirásková 5
Authors‘ workplace: Oční klinika Lékařské fakulty v Plzni Univerzity Karlovy v Praze a Fakultní nemocnice Plzeň Přednosta: doc. MUDr. Renata Říčařová, CSc., FEBO 1;  1. interní klinika Lékařské fakulty v Plzni Univerzity Karlovy v Praze a Fakultní nemocnice Plzeň Přednosta: prof. MUDr. Martin Matějovič, PhD. 2;  Neurologická klinika Lékařské fakulty v Plzni Univerzity Karlovy v Praze a Fakultní nemocnice Plzeň Přednosta: MUDr. Jiří Polívka, CSc. 3;  Neurochirurgická klinika Lékařské fakulty v Plzni Univerzity Karlovy v Praze a Fakultní nemocnice Plzeň Přednosta: doc. MUDr. Vladimír Přibáň, PhD. 4;  Oční klinika Lékařské fakulty v Hradci Králové Univerzity Karlovy v Praze a Fakultní nemocnice Hradec Králové Přednosta: prof. MUDr. Naďa Jirásková, Ph. D., FEBO 5
Published in: Prakt. Lék. 2017; 97(2): 73-81
Category: Of different specialties

Overview

Objective:
The aim of this paper is to present the idiopathic intracranial hypertension issue and it‘s diagnostics in cohort of 12 patients and to point out diagnostic and monitoring optical coherence tomography – OCT yield in IIH studied cohort. To assess statistically, if there is a significant reduction of retinal nerve fibre layer thickness measured before and during the treatment. The next objective is to mention the OCT benefit in cases, when an ophthalmological finding is ambiguous and when, with the aid of OCT, it is possible to distinguish a beginning oedema or a hardly noticeable optic nerve head atrophy.

Methods:
The cohort consists of 12 IIH patients with the age from 8 to 53 years who have been examined in our department since November 2013 till now. The detailed ophthalmological examination was performed. All patients underwent graphical examination of the head. They were examined by neurologist. They all underwent lumbar puncture, with the exception of one, where the cerebrospinal fluid pressure was measured.

Results:
We proved, that RNFL got thinner during the treatment and descending RNFL thickness correlates with the withdrawal of patient´s difficulties and with opthalmoscopicaly detectable optic nerve head oedema recession. Statistical analysis of measured data points out OCT benefit in IIH diagnostics. We proved by our treated patients with the reduction of optic nerve head oedema radical relief from headaches and practically total withdrawal of visual troubles upon reaching the normal vision.

Conclusion:
The optical coherence tomography supports ophthalmological examination and objectify clinical finding by the retinal structures measurement. Optical coherence tomography could better identify changes uneasily noticeable by the naked eye and could also interpret the stage of papilledema. Optical coherence tomography is the perspective method, which with exception of definite use in vitreoretinal diagnostic field found its stable place in IIH diagnostics in context with the other examinations.

KEYWORDS:
optical coherence tomography – idiopathic intracranial hypertension – retinal nerve fibre layer thickness – papilledema


Sources

1. Auinger P, Durbin M, Feldon S, et al. Papilledema outcomes from the Optical Coherence Tomography Substudy of the Idiopathic Intracranial Hypertension Treatment Trial. Ophthalmology 2015; 122(9): 1939–1945.

2. Digre KB, Nakamoto BK, Warner JEA, et al. A comparison of idiopathic intracranial hypertension with and without papilledema. Headache 2009; 49: 185–193.

3. Durcan FJ, Corbett JJ, Wall M. The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana. Arch Neurol 1988; 45: 875–877.

4. Faz G, Butler IJ, Koenig MK. Incidence of papilledema and obesity in children diagnosed with idiopathic benign” intracranial hypertension: case series and review. J Child Neurol 2010; 25: 1389–1392.

5. Frisén L. Swelling of the optic nerve head: a staging scheme. J Neurol Neurosurg Psychiatr 1982; 45: 13–18.

6. Frischholz M, Sarmento L, Wenzwl M, et al. Telemetric implantable pressure sensor for short- and long-term monitoring of intracranial pressure. Conf Proc IEEE Eng Med Biol Soc 2007; 2007: 514.

7. Jirásková N. Idiopatická intrakraniální hypertenze (pseudotumor mozku). Česk Slov Oftalmol 2000; 56: 262–265.

8. Kalantari H, Jaiswal R, Bruck I, et al. Correlation of optic nerve sheath diameter measurements by computed tomography and magnetic resonance imaging. Am J Emerg Med. 2013; 31: 1595–1597.

9. Otradovec J. Klinická neurooftalmologie. Praha: Grada Publishing 2003.

10. Radhakrishnan K, Ahlskog JE, Cross SA, et al. Idiopathic intracranial hypertension (pseudotumor cerebri). Descriptive epidemiology in Rochester, Minn, 1976 to 1990. Arch Neurol 1993; 50: 78–80.

11. Radovnický T., Vachata P., Sameš M. Telemetrický monitoring intrakraniálního tlaku v diagnostice hydrocefalu a nitrolební hypertenze. Cesk Slov Neurol N 2013; 76/109(6): 723–727.

12. Scott C, Kardon R, Lee A, et al. Diagnosis and grading of papilledema in patients with raised intracranial pressure using optical coherence tomography vs clinical expert assessment using a clinical staging scale. Arch Ophthalmol 2010; 128(6): 705–711.

13. Vartin V, Nguyen A, Balmitgere T, et al. Detection of mild papilledema using spectral domain optical coherence tomography. Br J Ophthalmol 2012; 96: 375–379.

14. Waisbourd M, Leibovitch I, Goldenberg D, Kesler A. OCT Assessment of morphological changes of the optic nerve head and macula in idiopathic intracranial hypertension. Clin Neurol Neurosurg 2011; 113(10): 839–843.

15. Welschehold S, Schmalhausen E, Dodier P, et al. First clinical results with a new telemetric intracranial pressure-monitoring system. Neurosurgery 2012; 70(1): 44–49.

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