September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
A restrospective analysis of translaminar, demographic, and physiologic parameters in relation to papilledema severity
Author Affiliations & Notes
  • David Fleischman
    Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, United States
  • Jennifer T Perry
    Ophthalmology, Brown University, Providence, Rhode Island, United States
  • Rand R Allingham
    Duke University Eye Center, Durham, North Carolina, United States
  • Sandra S Stinnett
    Duke University Eye Center, Durham, North Carolina, United States
  • Gita M Fleischman
    Otolaryngology, Head & Neck Surgery, University of North Carolina, Durham, North Carolina, United States
  • Syndee J Givre
    Raleigh Neurology Associates, Raleigh, North Carolina, United States
  • David A Chesnut
    Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, United States
  • Footnotes
    Commercial Relationships   David Fleischman, None; Jennifer Perry, None; Rand Allingham, None; Sandra Stinnett, None; Gita Fleischman, None; Syndee Givre, None; David Chesnut, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4545. doi:
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      David Fleischman, Jennifer T Perry, Rand R Allingham, Sandra S Stinnett, Gita M Fleischman, Syndee J Givre, David A Chesnut; A restrospective analysis of translaminar, demographic, and physiologic parameters in relation to papilledema severity. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4545.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Some case reports suggest that the translaminar pressure difference is important in cases of papilledema. The purpose of this study was to determine ocular, physiologic and demographic factors associated with papilledema severity.

Methods : A retrospective review of optic nerve photographs by two masked experts was used to grade papilledema severity using the Modified Frisén Scale (MFS). Patients who had undergone a diagnostic lumbar puncture and had a diagnosis of papilledema in conjunction with idiopathic intracranial hypertension between 2004 and 2012 were included for analysis. Those with any systemic or neurologic disease that could affect CSFP were excluded. Patients on acetazolamide were excluded. Assessments within one MFS grade were averaged and correlated to intraocular pressure, cerebrospinal fluid pressure, translaminar pressure differential, Modified Frisen Score, age, weight, height, and systolic and diastolic blood pressure.

Results : Sixty of 151 patients met all inclusion criteria, and 120 eyes were eligible for investigation. In univariate and multivariate type 3 generalized estimating equation (GEE) analyses, only age (Z: -2.70, p<0.01) and sex (Z=2.81; p<0.0001) were significantly correlated with MFS.

Conclusions : Papilledema severity decreased with advancing age, and was higher for female sex. We found no association between severity of papilledema and cerebrospinal fluid pressure (CSFP), intraocular pressure (IOP), blood pressure, or any other physiologic parameter. Factors other than the translaminar pressure differential may be important in determining the severity of papilledema. A controlled prospective study is needed to validate these results.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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