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Title: Optical coherence tomography angiography in papilledema compared with pseudopapilledema
Authors: Masoud Aghsaei Fard
Alireza Sahraiyan
Jalil Jalili
Marjane Hejazi
Yanin Suwan
Robert Ritch
Prem S. Subramanian
Tehran University of Medical Sciences
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
University of Colorado Health Sciences Center
New York Eye and Ear Infirmary
Keywords: Medicine
Issue Date: 1-Jan-2019
Citation: Investigative Ophthalmology and Visual Science. Vol.60, No.1 (2019), 168-175
Abstract: © 2019 The Authors. PURPOSE. The purpose of this study is to evaluate differences in optical coherence tomography angiography (OCT-A) findings between patients with papilledema and pseudopapilledema. METHODS. In this prospective, comparative study, 41 eyes of 21 subjects with papilledema, 27 eyes of 15 subjects with pseudopapilledema, and 44 eyes of 44 healthy normal subjects were included and were imaged using OCT-A. In addition to peripapillary total vasculature maps obtained with commercial vessel density mapping, major vessel removal using customized image analysis software was also used to measure whole image capillary density and peripapillary capillary density (PCD). Peripapiilary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) were recorded. RESULTS. Average RNFL thicknesses were greater in papilledema eyes than in pseudopapilledema and control subjects. GCC thickness was not different among three groups. Peripapillary vasculature values were significantly lower in papilledema (58.5 ± 6.1%) and pseudopapilledema (58.9 ± 4.7%) eyes compared with healthy eyes (63.2 ± 3.1%) using commercial machine software, without a difference between papilledema and pseudopapilledema eyes. However, using our customized software, peripapillary ‘‘capillary’’ density of papilledema eyes was 29.8 ± 9.4%, which was not significantly different from healthy subjects (31.8 ± 7.4%; P = 0.94). Pseudopapilledema eyes with peripapillary density of 25.5 ± 8.3% had significantly lower capillary values compared with control eyes (P = 0.01). There was a significantly lower whole image and nasal sector peripapillary capillary density of inner retina in pseudopapilledema eyes than papilledema eyes (P = 0.03 and P = 0.02, respectively). CONCLUSIONS. Whole image and nasal peripapillary sector capillary densities using OCT-A had diagnostic accuracy for differentiating true and pseudo-disc swelling.
ISSN: 15525783
Appears in Collections:Scopus 2019

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