Assessment of Optic Nerve Head Changes in Patients with Papilledema Using Spectral-Domin Optical Coherence Tomography

Abstract

Background: Swelling of the optic disc caused by axoplasmic flow stasis in the optic nerve head as a consequence of elevated intracranial pressure is referred to as papilledema (PO) (ICP). Measurements of the ONH and retinal layers using optical coherence tomography (OCT) imaging are reliable and reproducible, including measurements of the average peripapillary retinal nerve fibre layer (RNFL) thickness, average total peripapillary retinal thickness (TRT), and comparisons for all OCT parameters reflecting swelling of the ONH or peripapillary retina. Papilledema (PO) has been shown to affect the optic nerve head (ONH), retinal nerve fibre layer (RNFL), peripapillary total retinal (PTR) thickness, and gaglion cell layer (GCL) by OCTA (OCT). 60 eyes were used in this investigation, which was a prospective casecontrol study. The patients were picked from Benha University Hospitals' outpatient ophthalmology clinic. Optic nerve group (A) consisted of 30 eyes from 30 healthy controls, 16 of whom had mild papilledema, and 14 of whom had moderate to severe papilledema, which was separated into two groups: Group B (16 patients) and Group C (14 patients). Patients with moderate to severe papilledema (C) had higher levels of ONHV than those with mild papilledema (B). Furthermore, the average ONHV in group (B) was higher than in group (A) (A). However, as compared to healthy people in group A, the CD ratio was lower in patients with papilledema in groups B and C. In group C, the average thickness of the RNFL was considerably larger in all quadrants than in group B.. In addition, group (B) had a thicker average RNFL than group (A). PTR thickness values in group (C) were considerably higher than those in group (A) in all quadrants (B). In addition, the average PTR thickness in group (B) was higher than that in group (A). The difference in GCL thickness between the two groups in our research was not statistically significant. The results of this research demonstrate that all of the OCT measures tested (CD/R, ONHV, PTR, RNFL) are useful in the diagnosis of PO. These metrics may also identify early papilledema, thus they can be used to track PO patients and see whether their condition improves or worsens as a result of therapy. When it comes to diagnosing and monitoring individuals with PO, the only criterion that has demonstrated no sensitivity is GCL.