Purchase this article with an account.
Andy Malem, Stephanie West, Gabriella De Salvo; Multicolor imaging in the assessment and diagnosis of optic disc swelling. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2238.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To examine the use of the recently developed Multicolor imaging (Heidelberg Spectralis) as an adjunct to traditional imaging modalities in the assessment of patients with suspected optic disc swelling, and to determine whether Multicolour (MC) can help in the differential diagnosis between true optic disc swelling and pseusopapilloedema.
Prospective consecutive study of 19 patients who presented to our clinic with suspected bilateral optic disc swelling. MC was performed on all patients in addition to fundoscopy, retinal nerve fiber layer optical coherence tomography (OCT) and fundus autofluorescence (FAF). MC combines three different wavelengths to enhance different retinal layers: 488nm (blue), 536nm (green) and 786nm near infrared (NIR). All images were analyzed by a medical retinal specialist.
Of the 19 cases, 12 (63%) were female and 7 (37%) were male, with an average age of 19. Diagnosis of true papilloedema versus pseudopapilloedema was confirmed in all patients with a multidisciplinary approach. In fact 17 (89%) patients had raised intracranial pressure (ICP) confirmed by lumbar puncture opening pressure or brain imaging, and 2 (11%) had optic disc drusen. In those with true optic disc swelling secondary to raised ICP, MC illustrated a green shift correlating to the thickened retinal nerve fiber layer (RNFL) seen both clinically and on the optic disc OCT. The disc margins were indistinguishable at the green reflectance and a double ‘shadow’ was seen on the NIR reflectance. Unlike those with raised ICP, the patients with optic disc drusen did not present a green shift on the MC image and the disc margins were well delineated by a ring of hyperreflectance seen at the green reflectance; no thickening of the RNFL was detected.
Our results show that MC is a useful additional imaging modality in the diagnosis of true swollen optic discs and can provide additional information to help determine the underlying diagnosis in true and pseudopapilloedema.
This PDF is available to Subscribers Only