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Tommaso Salgarello, Benedetto Falsini, Salvatore Tedesco, Maria Elena Galan, Alberto Colotto, Luigi Scullica; Correlation of Optic Nerve Head Tomography with Visual Field Sensitivity in Papilledema. Invest. Ophthalmol. Vis. Sci. 2001;42(7):1487-1494.
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purpose. To quantify the relationship between optic nerve head tomography and
perimetric sensitivity in patients with papilledema.
methods. Eight patients with variable degrees of recently diagnosed papilledema
associated with idiopathic intracranial hypertension (IIH) were
evaluated with confocal scanning laser ophthalmoscopy (CSLO) and
automated perimetry. Patients were followed up with serial
measurements over a period of 5 to 30 months (mean ± SD,
17.1 ± 9), while under medical treatment (acetazolamide). The
tomographic parameters, volume above reference (VAR), volume above
surface (VAS), effective mean height (EMH), and maximum height in
contour (MxHC), were obtained by tomography, either globally or from
predefined disc sectors. The perimetric indices, mean deviation (MD)
and pattern SD (PSD), were evaluated. The results from patients’ right
eyes and the individual intereye differences in both tomographic and
perimetric parameters, were statistically evaluated by nonparametric
correlational (Spearman) and repeated measures (Wilcoxon) analyses.
results. At baseline, all tomographic parameters were negatively correlated with
MD in global (r = −0.8) and sectorial (r= −0.6) evaluations. The interocular differences in overall
tomographic parameters were correlated with corresponding differences
in perimetric MD (r = −0.8) and PSD (r = 0.6). During the follow-up period, volumetric disc parameters decreased
(P < 0.02), whereas perimetric MD increased
(P = 0.02) at comparable times.
conclusions. In patients with recently diagnosed papilledema, optic nerve head
tomographic abnormalities are quantitatively correlated with visual
field sensitivity losses. Therapeutic improvement of volumetric
parameters may be paralleled by recovery in perimetric sensitivity. The
data support the possible use of both techniques in combination to
monitor the amount of papilledema and the effectiveness of treatments
designed to reduce intracranial hypertension.
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