Journal article
The sensitivity and specificity of retinal and choroidal folds to distinguish between mild papilloedema and pseudopapilledema
Eye (London), Vol.35(11), pp.3131-3136
01/19/2021
DOI: 10.1038/s41433-020-01368-y
PMID: 33469131
Abstract
To determine if the presence or absence of retinal and choroidal folds on SD-OCT imaging can distinguish between mild papilloedema and pseudopapilledema.
Cross-sectional cohort study METHODS: Subjects with optic disc elevation (Frisen grades 1 and 2 only) were eligible to be enrolled prospectively. Pseudopapilledema was defined as a lack of change in optic disc appearance between two visits <6 months apart, and papilloedema was defined as change in optic disc appearance between two visits <6 months apart determined by review of fundus photographs by a masked neuro-ophthalmologist. Three masked neuro-ophthalmologists independently reviewed en face and axial optical coherence tomography (OCT) images of the optic nerve of the study subjects for the presence or absence of retinal and choroidal folds. Concordance was determined when there was agreement between at least 2 of the 3 observers.
Forty-five subjects (78 eyes) met inclusion criteria. There were 32 eyes with papilloedema and 46 eyes with pseudopapilledema. Choroidal and/or retinal folds were detected in 38% of eyes (12/32) with papilloedema and 19.6% of eyes (9/46) with pseudopapilledema. Post-hoc analyses eliminated six questionable cases of pseudopapilledema that had ancillary testing suggestive of elevated intracranial pressure and resulted in one remaining eye (2%) with more certain pseudopapilledema that was found to have folds. En face OCT imaging was more sensitive (71%) in detection of folds than axial OCT imaging (57%).
Choroidal and/or retinal folds on OCT are commonly observed in patients with mild papilloedema and are uncommon in those with pseudopapilledema. The presence of folds on OCT in patients presenting with disc elevation suggests papilloedema.
Details
- Title: Subtitle
- The sensitivity and specificity of retinal and choroidal folds to distinguish between mild papilloedema and pseudopapilledema
- Creators
- Sara N Reggie - Department of Ophthalmology, University of Tennessee Health Sciences Center, 930 Madison Ave #200, Memphis, TN, 38103, USA. snreggie@gmail.comRobert A Avery - Neuro-ophthalmology Service, Division of Ophthalmology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USAJames C Bavinger - Department of Neuro-ophthalmology, Departments of Ophthalmology and Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USAImran Jivraj - Department of Ophthalmology and Visual Sciences, University of Alberta, 2319 Active Treatment Centre, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3V9, CanadaCesar Alfaro - Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029-5674, USAMaxwell Pistilli - Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, 3711 Market Street, Suite 801, Philadelphia, PA, 19103, USAAnita A Kohli - Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, Suite 1B, New Haven, CT, 06510, USAGrant T Liu - Neuro-ophthalmology Service, Division of Ophthalmology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USAKenneth S Shindler - Department of Neuro-ophthalmology, Departments of Ophthalmology and Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USAAhmara G Ross - Department of Neuro-ophthalmology, Departments of Ophthalmology and Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USARandy H Kardon - Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, And Iowa City VA Healthcare System, 11290D PFP, Iowa City, IA, 52242, USAPatrick A Sibony - Department of Ophthalmology, State University of New York at Stony Brook, University Hospital and Medical Center, Stony Brook, New York, 11794, USAMadhura Tamhankar - Department of Neuro-ophthalmology, Departments of Ophthalmology and Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Resource Type
- Journal article
- Publication Details
- Eye (London), Vol.35(11), pp.3131-3136
- DOI
- 10.1038/s41433-020-01368-y
- PMID
- 33469131
- NLM abbreviation
- Eye (Lond)
- ISSN
- 0950-222X
- eISSN
- 1476-5454
- Publisher
- England
- Language
- English
- Date published
- 01/19/2021
- Academic Unit
- Iowa Neuroscience Institute; Ophthalmology and Visual Sciences
- Record Identifier
- 9984070733402771
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