Risk factors associated with progression from papilloedema to optic atrophy: results from a cohort of 113 patients
Background The aim of this study was to assess the risk factors for atrophic progression of patients with papilloedema secondary to intracranial hypertension, using optical coherence tomography parameters.Methods A retrospective study was conducted at Marseille University Hospitals’ Ophthalmology de...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open Ophthalmology |
| Online Access: | https://bmjophth.bmj.com/content/8/1/e001375.full |
| _version_ | 1797367556008312832 |
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| author | Bertrand Audoin Sarah Demortiere Penelope Tilsley Ruben Attia Ruben Fitoussi Kevin Mairot Jan-Patrick Stellman Thierry David Natacha Stolowy |
| author_facet | Bertrand Audoin Sarah Demortiere Penelope Tilsley Ruben Attia Ruben Fitoussi Kevin Mairot Jan-Patrick Stellman Thierry David Natacha Stolowy |
| author_sort | Bertrand Audoin |
| collection | DOAJ |
| description | Background The aim of this study was to assess the risk factors for atrophic progression of patients with papilloedema secondary to intracranial hypertension, using optical coherence tomography parameters.Methods A retrospective study was conducted at Marseille University Hospitals’ Ophthalmology departments between December 2015 and December 2021. All patients with papilloedema resulting from elevated intracranial hypertension at the initial presentation were included. Ophthalmological evaluations included analysing retinal nerve fibre layer (RNFL), ganglion cell layer (GCL) and total peripapillary retinal thickness (RT).Results The study included 222 eyes from 113 patients. The main aetiologies of intracranial hypertension were idiopathic intracranial hypertension (49/113), intracranial tumours (33/113) and cerebral venous thrombosis (15/113). The initial RNFL and RT showed significant correlations with optic atrophy. The mean RNFL was 199.63 µm in the ‘no atrophy’ group and 365.28 µm in the ‘atrophy’ group (p<0.001). Similarly, the mean RT was 483.72 µm in the ‘non-atrophy’ group and 796.69 µm in the ‘atrophy’ group (p<0.001). The presence of peripapillary haemorrhages showed a strong correlated with optic atrophy with an OR=19.12 (p<0.001). Impaired initial visual acuity was also associated with final optic atrophy with an OR=7.76 (p=0.020). Furthermore, impaired initial GCL was a major predictor of optic atrophy (OR=18.25 (p=0.021)).Conclusion Our study highlights the risk factors for optic atrophy in papilloedema, aiming to facilitate the early detection of patients at a high risk of vision loss and enable more aggressive medical or surgical management. |
| first_indexed | 2024-03-08T17:20:01Z |
| format | Article |
| id | doaj.art-9e026cf491914bb6a9c7eb9fd7fc260c |
| institution | Directory Open Access Journal |
| issn | 2397-3269 |
| language | English |
| last_indexed | 2024-03-08T17:20:01Z |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Ophthalmology |
| spelling | doaj.art-9e026cf491914bb6a9c7eb9fd7fc260c2024-01-03T08:15:08ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692023-12-018110.1136/bmjophth-2023-001375Risk factors associated with progression from papilloedema to optic atrophy: results from a cohort of 113 patientsBertrand Audoin0Sarah Demortiere1Penelope Tilsley2Ruben Attia3Ruben Fitoussi4Kevin Mairot5Jan-Patrick Stellman6Thierry David7Natacha Stolowy8Neurology, Hospital Timone, Marseille, FranceNeurology, Hospital Timone, Marseille, FranceNeuroimaging service, CRMBM, Marseille, FranceOphthalmology, Hospital Timone, Marseille, FranceOphthalmology, Hospital Timone, Marseille, FranceOphthalmology, Hospital Timone, Marseille, FranceNeuroimaging service, CRMBM, Marseille, FranceOphthalmology, Hospital Timone, Marseille, FranceOphthalmology, Hospital Timone, Marseille, FranceBackground The aim of this study was to assess the risk factors for atrophic progression of patients with papilloedema secondary to intracranial hypertension, using optical coherence tomography parameters.Methods A retrospective study was conducted at Marseille University Hospitals’ Ophthalmology departments between December 2015 and December 2021. All patients with papilloedema resulting from elevated intracranial hypertension at the initial presentation were included. Ophthalmological evaluations included analysing retinal nerve fibre layer (RNFL), ganglion cell layer (GCL) and total peripapillary retinal thickness (RT).Results The study included 222 eyes from 113 patients. The main aetiologies of intracranial hypertension were idiopathic intracranial hypertension (49/113), intracranial tumours (33/113) and cerebral venous thrombosis (15/113). The initial RNFL and RT showed significant correlations with optic atrophy. The mean RNFL was 199.63 µm in the ‘no atrophy’ group and 365.28 µm in the ‘atrophy’ group (p<0.001). Similarly, the mean RT was 483.72 µm in the ‘non-atrophy’ group and 796.69 µm in the ‘atrophy’ group (p<0.001). The presence of peripapillary haemorrhages showed a strong correlated with optic atrophy with an OR=19.12 (p<0.001). Impaired initial visual acuity was also associated with final optic atrophy with an OR=7.76 (p=0.020). Furthermore, impaired initial GCL was a major predictor of optic atrophy (OR=18.25 (p=0.021)).Conclusion Our study highlights the risk factors for optic atrophy in papilloedema, aiming to facilitate the early detection of patients at a high risk of vision loss and enable more aggressive medical or surgical management.https://bmjophth.bmj.com/content/8/1/e001375.full |
| spellingShingle | Bertrand Audoin Sarah Demortiere Penelope Tilsley Ruben Attia Ruben Fitoussi Kevin Mairot Jan-Patrick Stellman Thierry David Natacha Stolowy Risk factors associated with progression from papilloedema to optic atrophy: results from a cohort of 113 patients BMJ Open Ophthalmology |
| title | Risk factors associated with progression from papilloedema to optic atrophy: results from a cohort of 113 patients |
| title_full | Risk factors associated with progression from papilloedema to optic atrophy: results from a cohort of 113 patients |
| title_fullStr | Risk factors associated with progression from papilloedema to optic atrophy: results from a cohort of 113 patients |
| title_full_unstemmed | Risk factors associated with progression from papilloedema to optic atrophy: results from a cohort of 113 patients |
| title_short | Risk factors associated with progression from papilloedema to optic atrophy: results from a cohort of 113 patients |
| title_sort | risk factors associated with progression from papilloedema to optic atrophy results from a cohort of 113 patients |
| url | https://bmjophth.bmj.com/content/8/1/e001375.full |
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