Baseline OCT measurements in the idiopathic intracranial hypertension treatment trial, part II: correlations and relationship to clinical features
OCT Sub-Study Committee for NORDIC Idiopathic Intracranial Hypertension Study Group, Peggy Auinger, Mary Durbin, Steven Feldon, Mona Garvin, Randy Kardon, John Keltner, Mark J Kupersmith, Patrick Sibony, Kim Plumb, Jui-Kai Wang, John S Werner, Michael Wall, James Corbett, Steven Feldon, Deborah Friedman, John Keltner, Karl Kieburtz, Mark Kupersmith, Michael P McDermott, Eleanor B Schron, David Katz, Tippi Hales, Cindy Casaceli, Rudrani Banik, Sanjay Kedhar, Flora Levin, Jonathan Feistmann, Katy Tai, Alex Yang, Karen Tobias, Melissa Rivas, Lorena Dominguez, Violete Perez, Reid Longmuir, Matthew Thurtell, Trina Eden, Randy Kardon, Robert Lesser, Yanina O'Neil, Sue Heaton, Nathalie Gintowt, Byron L Lam, Joshua Pasol, Potyra R Rosa, Alexis Morante, Jennifer Verriotto, David Katz, Tracy Asbury, Robert Gerwin, Mary Barnett, Steven Hamilton, Caryl Tongco, Beena Gangadharan, Eugene May, Anil Patel, Bradley Farris, R Michael Siatkowsk, Heather Miller, Vanessa Bergman, Kammerin White, Steven O'Dell, Joseph Andrezik, Timothy Tytle, Kenneth Shindler, Joan Dupont, Rebecca Salvo, Sheri Drossner, Susan Ward, Jonathan Lo, Stephanie Engelhard, Elizabeth Windsor, Sami Khella, Madhura Tamhankar, Gregory Van Stavern, Jamie Kambarian, Renee Van Stavern, Karen Civitelli, J Banks Shepherd, Michael Vaphiades, Jason Swanner, A Blane Jett, Karen Searcey, Frankie Webb, Ashley Knight, Shereka Lewis, Lanning Kline, Ronald Braswell, Syndee J Givre, Tippi Hales, Penni Bye, Keisha Fuller, Kenneth M Carnes, Kimberly James, Marisol Ragland, Sophia M Chung, Dawn M Govreau, John T Lind, Zoe Williams, George O'Gara, Kari Steinmetz, Mare Perevich, Karen Skrine, Elisabeth Carter, Rajeev Ramchandran, Steven Katz, Marc Criden, Gina Coman, John McGregor, Andrea Inman, Prem S Subramanian, Paul N Hoffman, Marianne Medura, M Michaele Hartnett, Madiha Siddiqui, Diane Brown, Ellen Arnold, Jeff Boring, Neil R Miller, Peter Quiros, Sylvia Ramos, Margaret Padilla, Lupe Cisneros, Anne Kao, Carlos Filipe Chicani, Kevin Na, Rosa Tang, Laura Frishman, Priscilla Cajavilca, Sheree Newland, Liat Gantz, Maria Guillermo Prieto, Anastas Pass, Nicky R Holdeman, William Fletcher, Suresh Subramaniam, Jeannie Reimer, Jeri Nickerson, Fiona Costello, Vivian Rismondo-Stankovich, Maureen Flanagan, Allison Jensen, Patrick Sibony, Ann Marie Lavorna, Mary Mladek, Ruth Tenzler, Robert Honkanen, Jill Miller-Horn, Lauren Krupp, Joseph Rizzo, Dean Cestari, Neal Snebold, Brian Vatcher, Christine Matera, Edward Miretsky, Judith Oakley, Josyane Dumser, Tim Alperen, Sandra Baptista-Pires, Ursula Bator, Barbara Barrett, Charlene Callahan, Sarah Brett, Kamella Zimmerman, Marcia Grillo, Karen Capaccioli, M Tariq Bhatti, LaToya Greene, Maria Cecilia Santiago-Turla, Noreen McClain, Mays El-Dairi, Charles Maitland, H Logan Brooks Jr, Ronda Gorsica, Brian Sherman, Joel Kramer, Robert Granadier, Tammy Osentoski, Kristi Cumming, Bobbie Lewis, Lori Stec, Betty Kovacs, Richard Weil, Xavier Pi-Sunyer, William Fisher, Dorothea Castillo, Valerie Davis, Lourdes Fagan, Rachel Hollar, Tammy Keenan, Peter MacDowell, John Keltner, Kim Plumb, Laura Leming, Chris Johnson, John Keltner, Jack Werner, Kim Plumb, Laura Leming, Danielle Harvey, Jan Bausch, Shan Gao, Xin Tu, Debbie Baker, Deborah Friedman, Karen Helles, Nichole McMullen, Bev Olsen, Larry Preston, Victoria Snively, Ann Stoutenburg, O Iyore Ayanru, Elizabeth-Ann Moss, Pravin Patel, Richard Mills, Maureen Maguire, William Hart Jr, Joanne Katz, David Kaufman, Cynthia McCarthy, John Selhorst, Kathleen Digre, James Corbett, Neil R Miller, Richard Mills, OCT Sub-Study Committee for NORDIC Idiopathic Intracranial Hypertension Study Group, Peggy Auinger, Mary Durbin, Steven Feldon, Mona Garvin, Randy Kardon, John Keltner, Mark J Kupersmith, Patrick Sibony, Kim Plumb, Jui-Kai Wang, John S Werner, Michael Wall, James Corbett, Steven Feldon, Deborah Friedman, John Keltner, Karl Kieburtz, Mark Kupersmith, Michael P McDermott, Eleanor B Schron, David Katz, Tippi Hales, Cindy Casaceli, Rudrani Banik, Sanjay Kedhar, Flora Levin, Jonathan Feistmann, Katy Tai, Alex Yang, Karen Tobias, Melissa Rivas, Lorena Dominguez, Violete Perez, Reid Longmuir, Matthew Thurtell, Trina Eden, Randy Kardon, Robert Lesser, Yanina O'Neil, Sue Heaton, Nathalie Gintowt, Byron L Lam, Joshua Pasol, Potyra R Rosa, Alexis Morante, Jennifer Verriotto, David Katz, Tracy Asbury, Robert Gerwin, Mary Barnett, Steven Hamilton, Caryl Tongco, Beena Gangadharan, Eugene May, Anil Patel, Bradley Farris, R Michael Siatkowsk, Heather Miller, Vanessa Bergman, Kammerin White, Steven O'Dell, Joseph Andrezik, Timothy Tytle, Kenneth Shindler, Joan Dupont, Rebecca Salvo, Sheri Drossner, Susan Ward, Jonathan Lo, Stephanie Engelhard, Elizabeth Windsor, Sami Khella, Madhura Tamhankar, Gregory Van Stavern, Jamie Kambarian, Renee Van Stavern, Karen Civitelli, J Banks Shepherd, Michael Vaphiades, Jason Swanner, A Blane Jett, Karen Searcey, Frankie Webb, Ashley Knight, Shereka Lewis, Lanning Kline, Ronald Braswell, Syndee J Givre, Tippi Hales, Penni Bye, Keisha Fuller, Kenneth M Carnes, Kimberly James, Marisol Ragland, Sophia M Chung, Dawn M Govreau, John T Lind, Zoe Williams, George O'Gara, Kari Steinmetz, Mare Perevich, Karen Skrine, Elisabeth Carter, Rajeev Ramchandran, Steven Katz, Marc Criden, Gina Coman, John McGregor, Andrea Inman, Prem S Subramanian, Paul N Hoffman, Marianne Medura, M Michaele Hartnett, Madiha Siddiqui, Diane Brown, Ellen Arnold, Jeff Boring, Neil R Miller, Peter Quiros, Sylvia Ramos, Margaret Padilla, Lupe Cisneros, Anne Kao, Carlos Filipe Chicani, Kevin Na, Rosa Tang, Laura Frishman, Priscilla Cajavilca, Sheree Newland, Liat Gantz, Maria Guillermo Prieto, Anastas Pass, Nicky R Holdeman, William Fletcher, Suresh Subramaniam, Jeannie Reimer, Jeri Nickerson, Fiona Costello, Vivian Rismondo-Stankovich, Maureen Flanagan, Allison Jensen, Patrick Sibony, Ann Marie Lavorna, Mary Mladek, Ruth Tenzler, Robert Honkanen, Jill Miller-Horn, Lauren Krupp, Joseph Rizzo, Dean Cestari, Neal Snebold, Brian Vatcher, Christine Matera, Edward Miretsky, Judith Oakley, Josyane Dumser, Tim Alperen, Sandra Baptista-Pires, Ursula Bator, Barbara Barrett, Charlene Callahan, Sarah Brett, Kamella Zimmerman, Marcia Grillo, Karen Capaccioli, M Tariq Bhatti, LaToya Greene, Maria Cecilia Santiago-Turla, Noreen McClain, Mays El-Dairi, Charles Maitland, H Logan Brooks Jr, Ronda Gorsica, Brian Sherman, Joel Kramer, Robert Granadier, Tammy Osentoski, Kristi Cumming, Bobbie Lewis, Lori Stec, Betty Kovacs, Richard Weil, Xavier Pi-Sunyer, William Fisher, Dorothea Castillo, Valerie Davis, Lourdes Fagan, Rachel Hollar, Tammy Keenan, Peter MacDowell, John Keltner, Kim Plumb, Laura Leming, Chris Johnson, John Keltner, Jack Werner, Kim Plumb, Laura Leming, Danielle Harvey, Jan Bausch, Shan Gao, Xin Tu, Debbie Baker, Deborah Friedman, Karen Helles, Nichole McMullen, Bev Olsen, Larry Preston, Victoria Snively, Ann Stoutenburg, O Iyore Ayanru, Elizabeth-Ann Moss, Pravin Patel, Richard Mills, Maureen Maguire, William Hart Jr, Joanne Katz, David Kaufman, Cynthia McCarthy, John Selhorst, Kathleen Digre, James Corbett, Neil R Miller, Richard Mills
Abstract
Purpose: The accepted method to evaluate and monitor papilledema, Frisén grading, uses an ordinal approach based on descriptive features. Part I showed that spectral-domain optical coherence tomography (SD-OCT) in a clinical trial setting provides reliable measurement of the effects of papilledema on the optic nerve head (ONH) and peripapillary retina, particularly if a 3-D segmentation method is used for analysis.(1) We evaluated how OCT parameters are interrelated and how they correlate with vision and other clinical features in idiopathic intracranial hypertension (IIH) patients.
Methods: A total of 126 subjects in the IIH Treatment Trial (IIHTT) OCT substudy had Cirrus SD-OCT optic disc and macula scans analyzed by using a 3-D segmentation algorithm to derive retinal nerve fiber layer (RNFL) thickness, total retinal thickness (TRT), retinal ganglion cell layer plus inner plexiform layer (GCL+IPL) thickness, and ONH volume. The SD-OCT parameter values were correlated with high- and low-contrast acuity, perimetric mean deviation, Frisén grading, and IIH features.
Results: At study entry, the average RNFL thickness, TRT, and ONH volume showed significant strong correlations (r ≥ 0.90) with each other. The same OCT parameters showed a strong (r > 0.76) correlation with Frisén grade and a mild (r > 0.24), but significant, correlation with lumbar puncture opening pressure. For all eyes at baseline, neither visual acuity (high or low contrast) nor mean deviation correlated with any OCT measure of swelling or GCL+IPL thickness.
Conclusions: In newly diagnosed IIH, OCT demonstrated alterations of the peripapillary retina and ONH correlate with Frisén grading of papilledema. At presentation, OCT measures of papilledema, in patients with newly diagnosed IIH and mild vision loss, do not correlate with clinical features or visual dysfunction. (ClinicalTrials.gov number, NCT01003639.).
Keywords: OCT; intracranial hypertension; lumbar puncture; papilledema.
Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.
Figures
Source: PubMed