The Role of Optical Coherence Tomography of the Optic Nerve Head in Follow up of Operated Idiopathic Intracranial Hypertension

Background: When diagnosing papilledema caused by idiopathic intracranial hypertension, a fast and non-invasive method is optical coherence tomography (OCT). This work aimed to determine the OCT&#039;s ability to predict for optic disc edema follow-up in patients undergoing cerebrospinal fluid (CSF) diversion procedures for patients who have idiopathic intracranial hypertension. Methods: This cross-sectional study included 36 participants with 72 scanned eyes for operated cases of idiopathic intracranial hypertension who were presented to the ophthalmology outpatient clinic of Zagazig University Hospitals for follow up. Optic nerve head examination and scanning was done using Spectral domain OCT. Results: The results demonstrated a statistically significant difference between the papilledema Frisen scale and the ICP (p=0.002), with a higher mean ICP value (37.7±5.27) observed in eyes with a grade of 5. The disc elevation mean value was 1131.1±91.48, which was highest in eyes with grade 5, indicating a statistically significant difference between the papilledema Frisen scale and disc elevation (p<0.001). A statically significant difference between papilledema Frisen scale and disc elevation at the 2nd reading after revision of shunt (p<0.05) as eyes with grade 5 showed higher 2nd reading after revision of shunt (p<0.001). Conclusion: Serial OCT examinations can detect subtle changes in optic nerve morphology that may not be detected by clinical examination alone. This early detection of structural abnormalities enables prompt intervention and optimization of treatment strategies, potentially preventing further vision loss.