OPTICAL COHERENCE TOMOGRAPHY IN PAPILLOEDEMA AND PSEUDO PAPILLOEDEMA WITH AND WITHOUT OPTIC NERVE HEAD DRUSEN

Abstract

Introduction: Papilloedema is swelling of the optic disc secondary to raised intracranial tension. It is associated with both vascular and mechanical changes at the optic nerve head. Pseudo papilloedema on the other hand has numerous causes and is associated with only mechanical changes without any vascular changes. Both these conditions cause Retinal Nerve Fibre Layer (RNFL) defects which can be picked up on Optical Coherence Tomography (OCT).1 Our study shows the differences in RNFL defects in different quadrants of optic nerve head in both these conditions. This is a prospective study of 90 eyes in 54 patients. The study was Materials And Methods: conducted between November 2018 and April 2019 over a period of 6 months. The OCT images of 60 eyes of 39 patients were done and compared with 30 normal eye OCT using Cirrus HD-OCT (Carl Zeiss Meditec Inc) by optic disc scan 200*200 protocol and HD cross. Results: In the eyes having papilloedema, 37% had increased RNFL thickness in all four quadrants, 40% had increased RNFL thickness in all quadrants except temporal. Eyes having pseudo papilloedema showed increased RNFL thickness in all quadrants in 5%, all except temporal quadrant in 31% cases, superior and inferior quadrants in 37%. Increased RNFL thickness in all quadrants is more suggestive of papilloe Conclusion: dema. 2 Nasal RNFL thickness plays a vital role in differentiating true from pseudo papilloedema.