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Clara L. Afonso, Carolina F. Falcochio, Maria Kiyoko Oyamada, Kenzo Hokazono, Mario Luiz R. Monteiro; Optical Coherence Tomography and Pattern Electrorretinogram in Eyes With Acute and Chronic Papilledema from Pseudotumor Cerebri Syndrome. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3918. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the ability of Fourier-domain optical coherence tomography (FD-OCT) macular thickness and the full-field pattern electrorretinogram (PERG) parameters to differentiate between eyes with papilledema and healthy eyes and its correlation.
Fifty-four eyes from 29 patients with acute or chronic papilledema from pseudotumor cerebri syndrome (PCS) and 70 eyes from 35 normals underwent FD-OCT (3D OCT-1000®, Topcon) examinations and ophthalmic evaluation including standard automated perimetry (SAP). Macular thickness measurements were determined in both groups. Twenty-one eyes of 11 patients and 31 eyes of 22 normals were also evaluated using full-field PERG. Amplitudes and peak times for the P50 and N95 waves using both 14 and 48 minutes of visual angle stimulus were measured. Comparisons were made using Student’s t test. Correlations between measurements were also verified. Receiver operating characteristic (ROC) curves were used to describe the ability of the parameters to discriminate the groups. Visual field was analyzed based on mean deviation (MD) and central MD, using the 16 central points, which were expressed in 1/Lambert units.
In eyes with papilledema, macular thickness parameters (mean ± SD) corresponding to the superior, temporal, inferior and nasal, inner and outer segments in papilledema eyes were: 283.6 ± 23.2; 270.3 ± 18.7; 281.6 ± 20.8; 285.8 ± 23.7; 244.3 ± 16.9; 230.5 ± 12.7; 238.6 ± 17.8 and 257.3 ± 23.2, respectively. Average macular thickness was 258.5 ± 17.2. Corresponding values from normal eyes were: 295.8 ± 17.9; 281.2 ± 15.7; 289.2 ± 17.6; 298.1 ± 16.8; 256.7 ± 15.4; 240.7 ± 13.5; 251.7 ± 16.7 and 276.9 ± 15.4. Average macular thickness measurement was 271.1 ± 13.1. All macular thickness parameters were significantly reduced in papilledema eyes compared to normals. Macular thickness measurements were strongly correlated with visual field sensitivity loss assessed with SAP. No significant differences were observed in any PERG parameters in both groups of eyes.
Eyes with papilledema show significant thinning of the retinal thickness on the macular area, which is associated with the severity of visual field damage in these eyes. On the other hand, PERG amplitude and peak time parameters does not seem to be altered in eyes with papilledema. Macular thickness measurements could potentially be used to evaluate the amount of ganglion cell loss in patients with pseudotumor cerebri syndrome.
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