Macular exudate in idiopathic intracranial hypertension affects outer retina and visual acuity.
Humans
Tomography, Optical Coherence
Female
Male
Visual Acuity
/ physiology
Adult
Pseudotumor Cerebri
/ physiopathology
Young Adult
Macula Lutea
/ diagnostic imaging
Nerve Fibers
/ pathology
Retinal Ganglion Cells
/ pathology
Middle Aged
Exudates and Transudates
/ metabolism
Intracranial Pressure
/ physiology
Imaging
Macula
Vision
Journal
BMJ open ophthalmology
ISSN: 2397-3269
Titre abrégé: BMJ Open Ophthalmol
Pays: England
ID NLM: 101714806
Informations de publication
Date de publication:
24 Sep 2024
24 Sep 2024
Historique:
received:
06
06
2024
accepted:
03
09
2024
medline:
25
9
2024
pubmed:
25
9
2024
entrez:
24
9
2024
Statut:
epublish
Résumé
Optical coherence tomography (OCT) is suggested as a potential tool for retinal biomarkers in idiopathic intracranial hypertension (IIH). We explored how macular exudate (ME) affects retinal structure in IIH and investigated its relationship with their clinical features. Patients diagnosed with IIH and matched controls were enrolled. ME detection was done on fundus photography; swept-source OCT was used to image and measure the retinal sublayer thicknesses, including the retinal nerve fibre layer, ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer (INL) and outer retinal layer (ORL). IIH patients underwent lumbar puncture where intracranial pressure (ICP) was assessed. 195 eyes from 98 IIH patients (42 eyes had ME) and 224 eyes from 112 controls were included. IIH patients had thicker INL and ORL compared with controls (both p<0.001) while IIH eyes with ME had thicker INL and ORL thicknesses compared with eyes without ME (both p<0.05). In IIH patients, the retinal sublayer thicknesses correlated with their ICP levels, and GCIPL thickness correlated with visual acuity (VA). Furthermore, ME was associated with higher ICP, worse papilledema and lower VA (all p<0.001). ME affects retinal thickness in IIH patients and is associated with more severe clinical features in IIH. OCT may provide biomarkers informative of clinical changes in IIH. Further longitudinal studies are needed to explore the evolution of ME and its relationship to VA and retinal structure.
Sections du résumé
BACKGROUND
BACKGROUND
Optical coherence tomography (OCT) is suggested as a potential tool for retinal biomarkers in idiopathic intracranial hypertension (IIH). We explored how macular exudate (ME) affects retinal structure in IIH and investigated its relationship with their clinical features.
METHODS
METHODS
Patients diagnosed with IIH and matched controls were enrolled. ME detection was done on fundus photography; swept-source OCT was used to image and measure the retinal sublayer thicknesses, including the retinal nerve fibre layer, ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer (INL) and outer retinal layer (ORL). IIH patients underwent lumbar puncture where intracranial pressure (ICP) was assessed.
RESULTS
RESULTS
195 eyes from 98 IIH patients (42 eyes had ME) and 224 eyes from 112 controls were included. IIH patients had thicker INL and ORL compared with controls (both p<0.001) while IIH eyes with ME had thicker INL and ORL thicknesses compared with eyes without ME (both p<0.05). In IIH patients, the retinal sublayer thicknesses correlated with their ICP levels, and GCIPL thickness correlated with visual acuity (VA). Furthermore, ME was associated with higher ICP, worse papilledema and lower VA (all p<0.001).
CONCLUSION
CONCLUSIONS
ME affects retinal thickness in IIH patients and is associated with more severe clinical features in IIH. OCT may provide biomarkers informative of clinical changes in IIH. Further longitudinal studies are needed to explore the evolution of ME and its relationship to VA and retinal structure.
Identifiants
pubmed: 39317461
pii: bmjophth-2024-001810
doi: 10.1136/bmjophth-2024-001810
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.