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A. Fazelat, E. Nam, H. W. Cohen, C. Wertenbaker; Correlation of Peripapillary Nerve Fiber Layer Thickness and Visual Field Defects in Idiopathic Intracranial Hypertension Using OCT and Humphrey Visual Field. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1187. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To assess how well ocular coherence tomography (OCT) nerve fiber layer analysis corresponds to Humphrey visual field (HVF) changes in patients undergoing medical treatment for acute papilledema secondary to idiopathic intracranial hypertension (IIH).
This is a retrospective chart review of nine patients who presented with acute papilledema secondary to IIH over a 2-year period. Patients underwent OCT, HVF 24-2, and complete ophthalmologic examination at every visit. The primary outcome measures were average nerve fiber layer (NFL) thickness in each eye and mean deviation of HVF in each eye. A within-person product-moment correlation coefficient (r) between average NFL thickness and mean deviation was calculated for each eye across visits. A mean (± sd) r and 95% confidence interval was calculated for the sample and tested against 0 with a one-sample t-test with 2-sided alpha of .05.
Of the nine patients, 2 were male, 1 had previously diagnosed and treated IIH (8 were new cases), and all but one patient were able to undergo medical treatment. The average age was 22.6 (11 to 46) years of age and the average follow-up time was 292 (10 to 650) days. Patients were evaluated as few as three and as many as six times. Mean individual correlations of average NFL thickness with mean deviation were significantly less than 0 for both left eye (-.50 ± .47, 95% CI: -.86, -.13) and right eye (-.50 ± .40, 95% CI -.81, -.19) with p =.01 for each.
If confirmed, our findings suggest that OCT NFL analysis can detect subtle improvement in papilledema that significantly correlates with improvement of visual field defects in acute idiopathic intracranial hypertension. OCT may provide the clinician with another useful modality to monitor treatment efficacy for patients with IIH.
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