Journal article
Retinal and Choroidal Folds in Papilledema
Investigative ophthalmology & visual science, Vol.56(10), pp.5670-5680
09/2015
DOI: 10.1167/iovs.15-17459
PMCID: PMC4562343
PMID: 26335066
Abstract
To determine the frequency, patterns, associations, and biomechanical implications of retinal and choroidal folds in papilledema due to idiopathic intracranial hypertension (IIH).
Retinal and choroidal folds were studied in patients enrolled in the IIH Treatment Trial using fundus photography (n = 165 study eyes) and spectral-domain optical coherence tomography (SD-OCT; n = 125). We examined the association between folds and peripapillary shape, retinal nerve fiber layer (RNFL) thickness, disc volume, Frisén grade, acuity, perimetric mean deviation, intraocular pressure, intracranial pressure, and refractive error.
We identified three types of folds in IIH patients with papilledema: peripapillary wrinkles (PPW), retinal folds (RF), and choroidal folds (CF). Frequency, with photos, was 26%, 19%, and 1%, respectively; SD-OCT frequency was 46%, 47%, and 10%. At least one type of fold was present in 41% of patients with photos and 73% with SD-OCT. Spectral-domain OCT was more sensitive. Structural parameters related to the severity of papilledema were associated with PPW and RF, whereas anterior deformation of the peripapillary RPE/basement membrane layer was associated with CF and RF. Folds were not associated with vision loss at baseline.
Folds in papilledema are biomechanical signs of stress/strain on the optic nerve head and load-bearing structures induced by intracranial hypertension. Folds are best imaged with SD-OCT. The patterns of retinal and choroidal folds are the products of a complex interplay between the degree of papilledema and anterior deformation of the load-bearing structures (sclera and possibly the lamina cribrosa), both modulated by structural geometry and material properties of the optic nerve head. (ClinicalTrials.gov number, NCT01003639.).
Details
- Title: Subtitle
- Retinal and Choroidal Folds in Papilledema
- Creators
- Patrick A Sibony - Department of Ophthalmology State University of New York at Stony Brook, Stony Brook, New York, United StatesMark J Kupersmith - St. Luke's-Roosevelt Hospital CenterSteven E Feldon - University of RochesterJui-Kai Wang - University of Iowa, Ophthalmology and Visual SciencesMona Garvin - University of Iowa, Electrical and Computer Engineering
- Resource Type
- Journal article
- Publication Details
- Investigative ophthalmology & visual science, Vol.56(10), pp.5670-5680
- Publisher
- United States
- DOI
- 10.1167/iovs.15-17459
- PMID
- 26335066
- PMCID
- PMC4562343
- ISSN
- 0146-0404
- eISSN
- 1552-5783
- Grant note
- U10 EY017281-01A1 / NEI NIH HHS 3U10EY017281-01A1S1 / NEI NIH HHS U10 EY017387 / NEI NIH HHS R01 EY023279 / NEI NIH HHS U10 EY017281 / NEI NIH HHS U10 EY017387-01A1 / NEI NIH HHS
- Language
- English
- Date published
- 09/2015
- Academic Unit
- Electrical and Computer Engineering; Ophthalmology and Visual Sciences
- Record Identifier
- 9984064499702771
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