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Peripapillary microperimetry for the diagnosis and follow-up of papilledema in cases treated for idiopathic intracranial hypertension.
Neurological Research ( IF 1.9 ) Pub Date : 2020-09-11 , DOI: 10.1080/01616412.2020.1820811
Gehad A Elnahry 1, 2 , Amr M Elemary 3 , Nashwa Badr Eldin 1 , Ashraf A Nossair 1 , Omar A Barrada 1 , Ayman G Elnahry 1
Affiliation  

ABSTRACT

Objectives

To evaluate the use of peripapillary microperimetry in the diagnosis and follow-up of medically and surgically treated cases of papilledema due to idiopathic intracranial hypertension (IIH).

Methods

This study was a prospective non-comparative observational case series of patients with IIH. All patients underwent full ophthalmological examination, radiological imaging, and lumbar puncture, as well as microperimetric measurements around the optic nerve head. Patients were classified into a medical group, treated by weight reduction and acetazolamide, and a surgical group, treated by optic nerve sheath fenestration. Peripapillary microperimetric examinations were done at presentation and after one-month of treatment. Findings were compared to values obtained from an age-matched healthy control group.

Results

The study included 78 eyes of 39 patients diagnosed with IIH and 32 eyes of 16 healthy control subjects. The average of the sum of the 12 peripapillary microperimetric thresholds for both eyes of IIH cases before treatment was 53.4±59.9 dB, while for controls it was 171±14.0 dB (p<0.001). After 1 month of treatment, it improved to 86.7±56.1 dB (p<0.001) in IIH cases. Analyzed separately, the medical group improved from 68.9±43.4 dB to 105.2±76.5 dB (p<0.001), while the surgical group improved from 13.5±21.9 dB to 54.9±35.5 dB (p<0.001). Several potential roles for peripapillary microperimetry use in IIH management were identified including confirming papilledema diagnosis, follow up of treatment, and selection of cases for surgery.

Conclusion

Microperimetry can accurately and quantitatively monitor changes in peripapillary retinal sensitivity in patients undergoing treatment for papilledema due to IIH.



中文翻译:

在特发性颅内高压治疗的病例中,用于诊断和随访视乳头水肿的视乳头周围显微术。

摘要

目标

评估 peripapillary microperimetry 在因特发性颅内高压 (IIH) 引起的内科和外科治疗的视乳头水肿病例的诊断和随访中的应用。

方法

本研究是一项针对 IIH 患者的前瞻性非比较观察性病例系列研究。所有患者都接受了全面的眼科检查、放射成像和腰椎穿刺,以及视神经乳头周围的显微测量。患者分为药物组,通过减重和乙酰唑胺治疗,手术组,通过视神经鞘开窗术治疗。在就诊时和治疗 1 个月后进行视乳头周围显微检查。结果与从年龄匹配的健康对照组获得的值进行了比较。

结果

该研究包括 39 名诊断为 IIH 的患者的 78 只眼和 16 名健康对照受试者的 32 只眼。治疗前IIH病例双眼的12个视乳头周围微视野阈值之和的平均值为53.4±59.9 dB,而对照组为171±14.0 dB(p<0.001)。治疗 1 个月后,IIH 病例改善至 86.7±56.1 dB(p<0.001)。单独分析,医疗组从 68.9±43.4 dB 改善到 105.2±76.5 dB(p<0.001),而手术组从 13.5±21.9 dB 改善到 54.9±35.5 dB(p<0.001)。确定了在 IIH 管理中使用 peripapillary microperimetry 的几个潜在作用,包括确认视乳头水肿诊断、随访治疗和选择手术病例。

结论

微视野测量可以准确和定量地监测因 IIH 引起的视乳头水肿而接受治疗的患者视乳头周围视网膜敏感性的变化。

更新日期:2020-09-11
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