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Optic Nerve Head and Macular Optical Coherence Tomography Measurements in Papilledema Compared With Pseudopapilledema

Aghsaei Fard, Masoud, MD, FICO; Okhravi, Sara, MD; Moghimi, Sasan, MD; Subramanian, Prem S., MD, PhD

Journal of Neuro-Ophthalmology: March 2019 - Volume 39 - Issue 1 - p 28–34
doi: 10.1097/WNO.0000000000000641
Original Contribution

Background: To compare macular and optic nerve head optical coherence tomography (OCT) measurements in mild to moderate papilledema and pseudopapilledema.

Methods: One hundred nineteen eyes of 61 patients with mild to moderate papilledema, 84 eyes of 48 patients with pseudopapilledema, and 60 eyes of 60 healthy normal individuals were enrolled in this cross-sectional study. Using Spectralis SD-OCT, macular scans with macular ganglion cell–inner plexiform layer (GCIPL) and macular retinal nerve fiber layer (RNFL) segmentation were performed and divided into 2 regions (inner and outer, with a diameter of 3 and 6 mm, respectively); in addition, Bruch membrane opening (BMO) area and peripapillary RNFL thickness were obtained.

Results: BMO area was similar in papilledema (1.83 ± 0.34 mm2), pseudopapilledema (1.85 ± 0.37 mm2), and controls (1.85 ± 0.32 mm2). Average inner region macular GCIPL thickness in the papilledema, pseudopapilledema, and control groups was 87.2 ± 14.4 μm, 90.8 ± 6.1 μm, and 91.2 ± 9.8 μm, respectively (P > 0.05). Outer temporal region macular GCIPL was significantly thinner in the papilledema group compared with control group (P = 0.01). By contrast, outer inferior and outer nasal macular RNFL sectors were significantly thicker in the papilledema group compared with control groups (P = 0.01 and P < 0.01, respectively). Those measures were not different between pseudopapilledema and control eyes.

Conclusions: In papilledema eyes, outer temporal region macular GCIPL thickness decreased and outer inferior and outer nasal macular RNFL sectors thickness increased compared with the control group. These changes were not observed in the pseudopapilledema group.

Eye Research Center (MAF, SO, SM), Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Ophthalmology (SM), University of California, San Francisco, San Francisco, California; and Department of Ophthalmology (PSS), University of Colorado School of Medicine, Aurora, Colorado.

Address correspondence to Prem S. Subramanian, MD, PhD, Department of Ophthalmology, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045; E-mail:

Supported in part by a Challenge Grant from Research to Prevent Blindness to the Department of Ophthalmology, University of Colorado School of Medicine.

The authors report no conflicts of interest.

© 2019 by North American Neuro-Ophthalmology Society