الفهرس | Only 14 pages are availabe for public view |
Abstract Papilledema, or optic disc swelling due to raised intracranial pressure, has been graded using the Frisen Scale. This scale uses visual features of the optic disc and peripapillary retina to stage optic disc edema. Its reproducibility has been validated but it is limited by use of an ordinal scale (Baumal, 2011). Optical coherence tomography (OCT) is a potential tool to quantify changes in the degree of papilledema and to monitor the efficacy of treatment interventions. First described by (Huang et al., 2011). OCT is a cross-sectional imaging technique that quantitatively assesses multiple layers of the retina, allowing measurement of the retinal nerve fiber layer (RNFL). Direct measurements are calculated by a computer algorithm to quantify the nerve fiber layer and total retinal thickness (Paunescu et al., 2014). OCT offers several advantages over conventional photographic imaging such as use with small pupil sizes and nuclear cataracts. Despite these advantages, limitations of OCT include the requirement for patient fixation stability during imaging without eye tracking and the failure of segmentation algorithms for defining RNFL thickness and total retinal thickness in eyes with severe papilledema (Parisi et al., 2013). Although fundus photographs require subjective interpretation, they show detailed topographic relationships of optic disc edema that may be difficult to quantify and document on clinical examination. Unlike OCT, photographic artifacts (eg, defocus or incorrect light exposure) that could interfere with interpretation are usually obvious (El-Dairi et al., 2017). We aimed to identify and correlate the role of the optical coherence tomography of the optic nerve head with the clinical grading of papilledema using frisen scale via digital fundus photographs. It is a randomized study in which 50 eyes with papilledema were included in the study from the patients attending in the outpatient clinic of Beni-Suef university hospital. Digital optic disc photographs of the right or left eye were selected for comparison with OCT optic nerve head images results. To correlate OCT results with clinical grading of papilledema using Frisen scale. Our results showed that there was highly significant association between grades of papilledema by optical coherence tomography and grades of papilledema by modified Frisen scale (p<0.001). There was a strong positive significant correlation between grades of papilledema by optical coherence tomography and grades of papilledema by modified Frisen scale (r= 0.871, P <0.001). |