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Abstract Details

Relationship Between Optic Nerve Angle, Intracranial Pressure, and Visual Outcomes in Patients with Idiopathic Intracranial Hypertension (IIH)
Neuro-ophthalmology/Neuro-otology
P9 - Poster Session 9 (12:00 PM-1:00 PM)
5-001
To determine the optic nerve angle (ONA) in patients with and without IIH, and to explore the relationship between ONA, CSF-opening pressure (CSF-OP) on lumbar puncture (LP), and visual function.
The tortuosity of the optic nerve can be quantified radiologically by measuring the angle of optic nerve deformation. In IIH patients, lowering the intracranial pressure (ICP) to a normal range by LP leads to straightening of the optic nerve and an increase in the measured ONA on MRI. It is uncertain if ONA can be used as a marker of ICP or if a relationship between ONA and visual function exists.
Retrospective study of patients with/without IIH, who had neuro-ophthalmologic assessment (visual acuity, Humphrey visual field [HVF], fundus photography) and MRI brain immediately followed by LP with CSF-OP. Sagittal ONA was measured on multiplanar T2-SPACE images on a DICOM viewer by two masked reviewers. Papilledema was also graded on fundus photographs (Frisén scale) by two masked reviewers.
Fifty-four IIH patients and 30 unmatched controls were included. The IIH group was six years younger (95%CI 2-10, p=0.002), had 8.7 kg/m2 heavier body-mass-index (4.9-12.5, p<0.001), and 26% more women (p=0.01) compared to controls. In both eyes, ONA was significantly smaller in IIH patients by 12o compared to controls (7o-17o, p<0.001). In the IIH group, there was no significant correlation between ONA and CSF-OP in either eye (right [OD] r=0.19; left [OS] r=0.18; p>0.15). ONA had no significant correlation with logMAR visual acuity (OD r=0.26, p=0.06; OS r=0.15; p=0.27), HVF mean deviation (OD r=0.0059; OS r=-0.069; p>0.63), or Frisén grade (OD Spearman’s rho=0.058; OS rho=0.14; p>0.30).
The ONA is a sign of raised ICP and is significantly smaller in IIH patients compared to controls, but does not correlate with CSF-OP, severity of papilledema, or visual function.
Authors/Disclosures
Benson Chen, PhD FRACP (Department of Neurology, Auckland City Hospital)
PRESENTER 		Dr. Chen has nothing to disclose.
Solmaz Asnafi, MD (JFK Medical Center) No disclosure on file
No disclosure on file
Beau B. Bruce, MD, FÂ鶹´«Ã½Ó³»­ (Centers for Disease Control & Prevention) Dr. Bruce has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Bayer.
No disclosure on file
No disclosure on file
Nancy J. Newman, MD, FÂ鶹´«Ã½Ó³»­ (Emory University School of Medicine) Dr. Newman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for GenSight. Dr. Newman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Chiesi. Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stoke. Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Phelcom. The institution of Dr. Newman has received research support from GenSight. Dr. Newman has received publishing royalties from a publication relating to health care. Dr. Newman has received publishing royalties from a publication relating to health care. Dr. Newman has received publishing royalties from a publication relating to health care.
Valerie Biousse, MD Dr. Biousse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gensights Biologic. Dr. Biousse has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Topcon. Dr. Biousse has received publishing royalties from a publication relating to health care. Dr. Biousse has received publishing royalties from a publication relating to health care.
Amit Saindane No disclosure on file