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Caroline Vasseneix, Michael Dattilo, Beau B Bruce, Nancy J Newman, Valerie Biousse, Jason Peragallo; The Relationship between Central Corneal Thickness (CCT) and Papilledema from Idiopathic Intracranial Hypertension (IIH).. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3311.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma studies have suggested that translaminar pressure gradients (TPG) may affect severity of optic nerve damage in glaucoma. It has been demonstrated that CCT could possibly be a risk factor for developing ophthalmic disease from an altered TPG. Alterations of TPG by decreasing intraocular pressure (IOP) have also been implicated in the development of papilledema. Subgroups of patients with IIH and papilledema are at higher risk for severe vision loss, including black patients, men, and patients with fulminant presentations. Our goal was to determine if CCT is related to severity of papilledema and vision loss in IIH.
CCT was systematically recorded in IIH patients seen between 03/2015-10/2016. Demographic data, medications, BMI, IOP, CSF opening pressure, visual acuity, color vision, visual fields, and Frisén grade of papilledema on review of fundus photography were collected. We examined associations between CCT and other variables of interest controlling for age, race, and sex using linear, logistic, and ordinal generalized estimating equation models to account for intereye correlations.
Our 100 IIH patients included 95/100 women; 35 white, 56 black, 9 other race; with a median age 31 years (IQR 24.8-36.2), median BMI 35.7 (31.1-43), and median follow up 10.7 months (1.6-20.2). Median CCT was 551μ OD (525-578) and 553μ OS (529-577). Among 142/200(71%) eyes with papilledema at presentation, 39(20%) were Frisén scale grade 1 or 2, 40(20%) grade 3, 16(8%) grade 4, and 8(4%) grade 5. Median visual acuity was 0 logMAR and 36% had a visual field defect at first and final presentation. There was no association between CCT and IOP, CSF opening pressure, BMI, severity of papilledema and final visual outcome, controlling for age, race, and sex.
IIH patients had a median CCT within the normal range. There was no association between CCT, IOP, or TPG and severity of papilledema or visual outcome.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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