Abstract
Abstract: :
Purpose: To determine the sensitivity of laser scanning tomography (Heidelberg Retina Tomograph II) in detecting clinically significant changes in papilledema and the correlation with visual field loss. Methods: Nine patients with variable degrees of recently diagnosed papilledema associated with idiopathic intracranial hypertension were evaluated with scanning laser tomography (HRT II) and automated perimetry (Humprey 30–2). Each patient underwent a complete ophthalmic evaluation: anterior segment examination, best–corrected visual acuity, fundus examination with papilledema evaluation. Patients were followed up with examinations over a period of one, three, six and nine months. The tomographic parameters C/D area ratio, Rima Area, Cup Area, Rim Volum, Cup Shape Measure, Cup Volum, Mean RNFL Thickness, Linear C/D ratio were obtained and compared among the follow–up examinations by HRT II software. Results:the disk area (5.485 mm2), rim area (5.461 mm2) and rim volume (2.440 cmm) values were greater than the mean values of disk area (1.69–2.82 mm2), rim area (1.20–1.78 mm2) and rim volume (–0.01–0.49 cmm) determined by tha HRT II, while the cup area (0.02 mm2) and cup volume (0.003 cmm) appeared to be close to zero. Between baseline and at the last follow–up visit were found high significant difference between the C/D area ratio, Rima Area, Cup Area, Rim Volum, Cup Shape Measure (p<0.0001), significant difference between Cup Volum, Mean RNFL Thickness, Linear C/D ratio (p<0.01),while there wasn’t a significant difference for the cup shape measure (p>0.05). It was very usefull to see the topography diffence image that demostrates significant reduction of the disc prominence during the follow–up period. Conclusions: In patients with recently diagnosed papilledema scanning laser tomography has a high sensivity for detecting small changes in disc areas and volumes. It can confirm therapeutic failure by detecting stable or increasing disc volume. Decreasing volumes and areas may indicate resolution of papilledema. In our opinion this tecnique can accompanying funduscopy in the monitoring of papilledema.
Keywords: neuro-ophthalmology: optic nerve • optic disc • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)