Yasin Farrokhi1, Shervin Sharif Kashani2, Masoud Aghsaei Fard3, Farzad Pakdel4, Samira Yadegari5. 1. Department of Radiology, Emam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran. 2. Department of Radiology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: kashanis@sina.tums.ac.ir. 3. Department of Neuro-ophthalmology and Strabismus, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. 4. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Orbit and Oculoplastic Surgery, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. 5. Department of Neuro-ophthalmology and Strabismus, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: yadegarisamira@yahoo.com.
Abstract
OBJECTIVE: Asymmetric papilledema (AP) is a rare condition in idiopathic intracranial hypertension (IIH). As the pathophysiology of papilledema developement in IIH remains unclear, the study of AP could clarify some etiologic aspects. We aimed to evaluate bony optic canal size in IIH patients with AP. PATIENTS AND METHODS: All IIH patients based on modified Dandy criteria in our referral tertiary eye hospital underwent neuro-opthalmologic exams and grading of papilledema according to modified Frisén scale. Very asymmetric papilledema (VAP) defined as a ≥2 grade difference between the two eyes. Clinical features, cerebrospinal fluid opening pressure (CSF OP), best corrected visual acuity, Humphery visual field, and brain magnetic resonance imaging (MRI) and MR venography was performed for all patients. Spiral orbital computed tomography (CT) scan which is the choice method for details of bony structures with axial, coronal and sagittal planes was done in patients with VAP. RESULT: 59 patients with IIH were diagnosed that 18.6% of them (n = 11) had VAP. There was no IIH patient with strictly unilateral Papilledema. Presenting symptoms and CSF OP was not significantly different between patients with symmetric and asymmetric papilledema. In patients with VAP, bony optic canal size was not statistically significant different in axial, coronal and sagittal plane when comparing the eye with higher grade edema to the fellow eye. CONCLUSION: Our study showed that bony optic canal size evaluated by orbital CT scan was not different in VAP in IIH patients. Finding the exact pathophysiology of AP need further studies.
OBJECTIVE: Asymmetric papilledema (AP) is a rare condition in idiopathic intracranial hypertension (IIH). As the pathophysiology of papilledema developement in IIH remains unclear, the study of AP could clarify some etiologic aspects. We aimed to evaluate bony optic canal size in IIH patients with AP. PATIENTS AND METHODS: All IIH patients based on modified Dandy criteria in our referral tertiary eye hospital underwent neuro-opthalmologic exams and grading of papilledema according to modified Frisén scale. Very asymmetric papilledema (VAP) defined as a ≥2 grade difference between the two eyes. Clinical features, cerebrospinal fluid opening pressure (CSF OP), best corrected visual acuity, Humphery visual field, and brain magnetic resonance imaging (MRI) and MR venography was performed for all patients. Spiral orbital computed tomography (CT) scan which is the choice method for details of bony structures with axial, coronal and sagittal planes was done in patients with VAP. RESULT: 59 patients with IIH were diagnosed that 18.6% of them (n = 11) had VAP. There was no IIH patient with strictly unilateral Papilledema. Presenting symptoms and CSF OP was not significantly different between patients with symmetric and asymmetric papilledema. In patients with VAP, bony optic canal size was not statistically significant different in axial, coronal and sagittal plane when comparing the eye with higher grade edema to the fellow eye. CONCLUSION: Our study showed that bony optic canal size evaluated by orbital CT scan was not different in VAP in IIH patients. Finding the exact pathophysiology of AP need further studies.
Authors: Angelique Van Ombergen; Steven Jillings; Elena Tomilovskaya; Floris L Wuyts; Peter Zu Eulenburg Journal: Proc Natl Acad Sci U S A Date: 2019-07-30 Impact factor: 11.205