OCT characteristics in Idiopahthic Intracranial Hypertension Michael Waisbourd, MD Igal Leibovitch, MD Dafna Goldenberg, MD Anat Kesler, MD Department of Ophthalmology Tel Aviv Medical Center

Objective To demonstrate the OCT characteristics in patients with IIH

Materials and Methods Retrospective review of medical records and OCT images of IIH patients ( ) Inclusion – Modified Dandy Criteria – Signs and symptoms of increased ICP – Normal neurologic examination with no localizing signs, except for CN VI palsy – Normal neuroimaging – Normal CSF chemistry and cytology with elevated opening pressure

Results 48 IIH patients (46F, 2M) Mean age 31y (13y-64y) Mean BMI 31 Kg\m 2 Mean LP 326 mmH 2 O

Results Visual Acuity – 20/20 to 20/ % – 20/30 to 20/ % – 20/50 to 20/ % – 20/120 to 20/ % – CF - 1.0% – NLP - 1.0% Automated visual field – Normal 68.8% – Nasal defect 17.7% – Mild constriction 2.1% – Temporal defect 1.0% – Severe constriction 1.0% – Data missing 9.4%

Results Peripapillary retinal nerve fiber layer (RNFL) was measured for each group by OCT NormalPapilledema

Results – average RNFL P=0.004

Normal\ mild elevation (N=20) Moderate elevation (N=51) Papilledema (N=20) P Value Mean95% CIMean95% CIMean95% CI Nasal68(58 – 79)84(76 – 93)98(82 – 118)0.007 Inferior117(102 – 134)146(134 – 159)184(158 – 214)<0.001 Temporal62(54 – 70)75(70 – 80)97(80 – 117)<0.001 Superior103(92 – 116)122(109 – 137)140(116 – 170)0.043

Conclusion OCT may assist in evaluating the optic nerve in IIH patients Prospective follow up of IIH patients by OCT is being investigated in a sequential study

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