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Optical coherence tomography application in diagnostics and monitoring of idiopathic intracranial hypertension patients


Authors: Z. Kasl 1;  Š. Rusňák 1;  T. Ishizaki 1;  M. Krčma 2;  M. Peterka 3;  V. Rohan 3;  J. Dostál 4;  N. Jirásková 5
Authors‘ workplace: Oční klinika Lékařské fakulty v Plzni Univerzity Karlovy v Praze a Fakultní nemocnice Plzeň Přednosta: doc. MUDr. Renata Říčařová, CSc., FEBO 1;  1. interní klinika Lékařské fakulty v Plzni Univerzity Karlovy v Praze a Fakultní nemocnice Plzeň Přednosta: prof. MUDr. Martin Matějovič, PhD. 2;  Neurologická klinika Lékařské fakulty v Plzni Univerzity Karlovy v Praze a Fakultní nemocnice Plzeň Přednosta: MUDr. Jiří Polívka, CSc. 3;  Neurochirurgická klinika Lékařské fakulty v Plzni Univerzity Karlovy v Praze a Fakultní nemocnice Plzeň Přednosta: doc. MUDr. Vladimír Přibáň, PhD. 4;  Oční klinika Lékařské fakulty v Hradci Králové Univerzity Karlovy v Praze a Fakultní nemocnice Hradec Králové Přednosta: prof. MUDr. Naďa Jirásková, Ph. D., FEBO 5
Published in: Prakt. Lék. 2017; 97(2): 73-81
Category: Of different specialties

Overview

Objective:
The aim of this paper is to present the idiopathic intracranial hypertension issue and it‘s diagnostics in cohort of 12 patients and to point out diagnostic and monitoring optical coherence tomography – OCT yield in IIH studied cohort. To assess statistically, if there is a significant reduction of retinal nerve fibre layer thickness measured before and during the treatment. The next objective is to mention the OCT benefit in cases, when an ophthalmological finding is ambiguous and when, with the aid of OCT, it is possible to distinguish a beginning oedema or a hardly noticeable optic nerve head atrophy.

Methods:
The cohort consists of 12 IIH patients with the age from 8 to 53 years who have been examined in our department since November 2013 till now. The detailed ophthalmological examination was performed. All patients underwent graphical examination of the head. They were examined by neurologist. They all underwent lumbar puncture, with the exception of one, where the cerebrospinal fluid pressure was measured.

Results:
We proved, that RNFL got thinner during the treatment and descending RNFL thickness correlates with the withdrawal of patient´s difficulties and with opthalmoscopicaly detectable optic nerve head oedema recession. Statistical analysis of measured data points out OCT benefit in IIH diagnostics. We proved by our treated patients with the reduction of optic nerve head oedema radical relief from headaches and practically total withdrawal of visual troubles upon reaching the normal vision.

Conclusion:
The optical coherence tomography supports ophthalmological examination and objectify clinical finding by the retinal structures measurement. Optical coherence tomography could better identify changes uneasily noticeable by the naked eye and could also interpret the stage of papilledema. Optical coherence tomography is the perspective method, which with exception of definite use in vitreoretinal diagnostic field found its stable place in IIH diagnostics in context with the other examinations.

KEYWORDS:
optical coherence tomography – idiopathic intracranial hypertension – retinal nerve fibre layer thickness – papilledema


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