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Ciro Tamburrelli, Tommaso Salgarello, Carmela Grazia Caputo, Andrea Giudiceandrea, Luigi Scullica; Ultrasonographic Evaluation of Optic Disc Swelling: Comparison with CSLO in Idiopathic Intracranial Hypertension. Invest. Ophthalmol. Vis. Sci. 2000;41(10):2960-2966.
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purpose. To determine the accuracy and reproducibility of ultrasonographic (US)
readings of optic disc elevations in patients with papilledema compared
with confocal scanning laser ophthalmoscope (CSLO) measurements.
methods. One randomly selected eye of 22 patients with idiopathic intracranial
hypertension (IIH) and a variable degree of optic disc swelling
underwent five and three repeated measurements of disc height using
high-resolution ultrasonography (Biovision unit; Quantel Medical,
Clermont–Ferrand, France) and CSLO (Heidelberg Retina Tomograph[
HRT]; Heidelberg Engineering, Heidelberg, Germany), respectively.
The same procedure was assessed in 14 subjects with variable degrees of
physiologic optic disc cupping. US and HRT measurements from each group
were individually compared with each other to estimate the accuracy of
US readings in both disc conditions in comparison with HRT data.
results. Ultrasonographic readings were positively correlated with HRT
measurements in both swollen (r = 0.62, P = 0.002) and excavated disc
(r = 0.84, P < 0.0002). The
95% limits of agreement between the instruments were 0.24 ± 0.59
mm (mean ± 2 SD) and 0.05 ± 0.3 mm for swelling and cupping
measurements, respectively. The coefficient of variation was 7.63% and
1.8% for swelling and 7.93% and 5.91% for cupping, with US and HRT,
conclusions. The results indicate that US and CSLO readings are correlated in both
disc swelling and cupping conditions, but to a different extent because
of a significant discrepancy in papilledema. US assessment can be
considered highly reproducible. Combined US and HRT optic disc analysis
may be recommended in papilledema evaluation as long as a better
correlation can be demonstrated in further
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