Effect of optic nerve sheath fenestration for idiopathic intracranial hypertension on retinal nerve fiber layer thickness

Starks, Victoria; Gilliland, Grant; Vrcek, Ivan; Gilliland, Connor

doi:10.3109/01676830.2016.1139592

Cited by 10 publications

(3 citation statements)

References 14 publications

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“…After decompressive surgery, axonal swelling may decrease and postoperative peripapillary RNFL thickness might reflect the amount of true optic nerve atrophy. A previous study that investigated the effect of optic nerve decompression using optic nerve sheath fenestration in patients with intracranial hypertension on peripapillary RNFL thickeness also revealed that the average RNFL thickness decreased to 103 μm from 114 μm postoperatively [28]. Also, delayed ganglion cell atrophy could lead to a progressive decrease in peripapaillary RNFL thickness postoperatively.…”

Section: Discussionmentioning

confidence: 94%

Changes in optical coherence tomography measurements after orbital wall decompression in dysthyroid optic neuropathy

Park

Kim

Woo

2018

Eye

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Section: Discussionmentioning

confidence: 94%

Changes in optical coherence tomography measurements after orbital wall decompression in dysthyroid optic neuropathy

Park

Kim

Woo

2018

Eye

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“…Thirdly, there is a lack of sensitive and objective predictors for monitoring relapses and remissions of IIH . Furthermore, there is no consensus on how long medical therapy of IIH should be continued and when a decision for surgical intervention should be made .…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography represents a sensitive and reliable tool for routine monitoring of idiopathic intracranial hypertension with and without papilledema

Huang‐Link

Eleftheriou

Yang

et al. 2019

Euro J of Neurology

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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.

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“… 43 When patients develop optic atrophy in the chronic period, RNFL thinning is already an expected outcome. 44 …”

Section: Discussionmentioning

confidence: 99%

Are All Retinal Nerve Fiber Layer Defects on Optic Coherence Tomography Glaucomatous?

Güngör¹,

Akman²

2017

tjo

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Objectives:In this study, we investigated the patients who were referred to our clinic with a prediagnosis of glaucoma based on retinal nerve fiber layer (RNFL) defects on optic coherence tomography (OCT) but were determined to have nonglaucomatous RNLF defects upon detailed examination.Materials and Methods:The ophthalmic examination notes, OCT images, Heidelberg retinal tomography (HRT) II and fundus photographs of 357 patients were retrospectively evaluated. Final diagnoses of these patients were investigated.Results:Of the 357 patients, 216 (60.5%) were diagnosed as open angle glaucoma, 33 (9.2%) as low-tension glaucoma, 39 (10.9%) as pre-perimetric glaucoma. The ophthalmic examinations of 14 patients (3.9%) were normal and there were no RNFL defects in OCT examinations after dilatation. In 39 patients (10.9%), the ophthalmic and optic disc examinations were completely normal and no etiologic factor explaining RNFL defects was found. Twenty-two eyes of 16 patients (4.5%) were included in this study (the mean age was 53.8±11.5 years; 9 men and 7 women). After detailed questioning of the medical history and systemic and neurologic examinations, a diagnosis of ischemic optic neuropathy was made in 11 eyes (10 patients) (2.8%), optic neuritis in 3 eyes (2 patients) (0.6%), optic disc drusen in 4 eyes (2 patients) (0.6%), pseudotumor cerebri in 2 eyes (1 patient) (0.3%), and cerebral palsy in 2 eyes (1 patient) (0.3%).Conclusion:Decrease in RNFL thickness on OCT images alone may be misleading in glaucoma examination. In cases where optic disc cupping is not evident, diagnosis should not be based on OCT RNFL examinations alone, and the patient’s medical history, detailed ophthalmic examination, OCT optic disc parameters, HRT, and visual field tests should all be carefully evaluated together.

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Effect of optic nerve sheath fenestration for idiopathic intracranial hypertension on retinal nerve fiber layer thickness

Cited by 10 publications

References 14 publications

Changes in optical coherence tomography measurements after orbital wall decompression in dysthyroid optic neuropathy

Changes in optical coherence tomography measurements after orbital wall decompression in dysthyroid optic neuropathy

Optical coherence tomography represents a sensitive and reliable tool for routine monitoring of idiopathic intracranial hypertension with and without papilledema

Are All Retinal Nerve Fiber Layer Defects on Optic Coherence Tomography Glaucomatous?

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