Journal of Clinical and Experimental Ophthalmology
Open Access
ISSN: 2155-9570
ISSN: 2155-9570
Mohammed E Mahdy
Zagazig University, Egypt
Scientific Tracks Abstracts: Clin Exp Ophthalmol
Introduction: Idiopathic Intracranial Hypertension (IIH), also referred to as benign intracranial hypertension, is a disorder generally
affecting overweight women of childbearing age. Idiopathic intracranial hypertension has often been considered a diagnosis of
exclusion, especially if no cranial neuropathies or papilloedema have been detected. Measurement of the Optic Nerve Sheath Diameter
(ONSD) using CT scan can provide a solution for this situation, as it has been used as a non-invasive method of ICP monitoring since
the mid-1990s. Another rapid non-invasive method for evaluation of patients with IIH is Optical Coherence Tomography (OCT).
Spectral-domain OCT provides reliable thickness and volume measurements of the optic nerve head and retina and can reliably
demonstrate structural changes due to papilloedema. This study included 40 patients (aged ≥18 years) presented with headache and
fulfilled modified Dandy criteria for IIH.
Method: We collected and analyzed data on the following variables: ONSD in the middle third of the intraorbital path (the point
where the ophthalmic artery crosses the optic nerve served as an anatomical landmark); Our patients underwent spectral domain
OCT (SD-OCT) scanning dual beam Spectralis laser tracking tomography Spectralis®, using a commercially available device (3D
OCT-1000; Topcon Corp., Tokyo, Japan). The scanning protocol involved the acquisition of a 6Ã?6 mm cube scan of the Optic Nerve
Head (ONH) and macula with a scan density of 512Ã?128 pixels.
Results: Our study included 40 female patients with clinico-radiological diagnosis of IIH with their age range from 22 to 42 years,
their main complaints were visual complaints as blurred vision and transient visual obscurations in 16 patients (40%), and headache
in 15 patients (37.5%), while 9 patients (22.5%) had both complaints (table 1). None of our patients developed side effects or allergic
reaction with the used contrast agent in orbital CT with contrast. The ONSD was nearly in the same range in both eyes (4-10 mm for
right and 4-11 mm for left) when measured by CT with contrast at the crossing point of ophthalmic artery (table2). More than 82%
(33) of patients diagnosed by OCT to have papilloedema while in 17% (7) of patients not (table 3). There was a statistical significant
relation between the ONSD by OCT in both right and left sides with the diagnosis of IIH (P =0.003 for right, P= 0.001 for left) while
there was no significant relation between PTC and patient's age (P= 0.921) (table 4). The estimated statistical cutoff value of ONSD
was 5.5 mm with sensitivity of 84.4% and a specificity to diagnose optic nerve thickening by 100% in the left side and 85.7% in the
right side (table 5, 6).
Conclusion: The addition of OCT to ONSD by CT+C can increase its diagnostic ability for the cases with IIH, which may reduce the
need for invasive diagnostic techniques like LP.
Mohammed Mahdy was born in Egypt 1982, He accomplished his education basic and postgraduate in Egypt, and he is a graduate from Zagazig University that was established in 1974, He finished his master degree in neuropsychiatry 2010, and MD in neurology 2016, He is working as neurology Lecturer in faculty of medicine, Zagazig University, and a member of the American Academy of Neurology, and now He works as a neurology consultant in Saudi airlines medical services.