OCT Based Interpretation of the Optic Nerve Head Anatomy and Prevalence of Optic Disc Drusen in Patients with Idiopathic Intracranial Hypertension (IIH).

Elisabeth Arnberg Wibroe,Steffen Hamann,Lasse Malmqvist

doi:10.3390/life11060584

Elisabeth Arnberg Wibroe, Steffen Hamann + Show 1 more

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https://doi.org/10.3390/life11060584

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Abstract

We aimed to systematically examine the optic nerve head anatomy in patients with idiopathic intracranial hypertension (IIH) using a standardized optical coherence tomography (OCT) protocol. The study retrospectively included 32 patients diagnosed from 2014 to 2021 with IIH. Using OCT, in accordance with a standardized scanning protocol for patients with optic disc drusen, the presence of optic disc drusen, prelaminar hyperreflective lines, peripapillary hyperreflective ovoid mass-like structures, the retinal nerve fiber layer thickness, and macular ganglion cell layer volume was obtained. Optic disc drusen were found in 3.1%, hyperreflective lines in 31.3%, and peripapillary hyperreflective ovoid mass-like structures in 81.3% of all IIH patients at least three months after the time of diagnosis. We found no significant differences in retinal nerve fiber layer thickness or macular ganglion cell layer volume in patients with hyperreflective lines or PHOMS respectively compared to patients without hyperreflective lines (p = 0.1285 and p = 0.1835). In conclusion, the prevalence of optic disc drusen in IIH patients is similar to the reported prevalence in the general population. The high prevalence of hyperreflective lines and peripapillary hyperreflective ovoid mass-like structures in IIH patients suggest these structures be a result of crowding in the optic nerve head caused by papilledema.

Highlights

Idiopathic intracranial hypertension (IIH) is an acquired condition of raised intracranial pressure (ICP) for unknown reasons, which leads to papilledema and subsequent axonal damage [1,2,3]
Patients were identified by searching the hospital digital medical journals for the diagnosis of IIH using the diagnostic code for IIH, “benign intracranial hypertension”, dg972
Optic disc drusen were found in 3.1%, hyperreflective lines in 31.3%, and peripapillary hyperreflective ovoid mass-like structures in 81.3% of all IIH patients at least three months after the time of diagnosis

Summary

Introduction

Idiopathic intracranial hypertension (IIH) is an acquired condition of raised intracranial pressure (ICP) for unknown reasons, which leads to papilledema and subsequent axonal damage [1,2,3]. The risk of acquiring the disease is 4–20 times higher for overweight women in the fertile age and the rising incidence significantly correlates with rising. BMI in both genders [4,6,7,8]. IIH is associated with social deprivation and adverse obstetric outcomes, but IIH can develop independently of gender, age, weight, and socioeconomic status [4,6,9]. Disease duration is months to years, and recurrence of the condition has been shown in up to 28% of the patients [6,10]. Signs of IIH can be papilledema and 6th nerve palsy [10]

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