Malhotra Kiran, Padungkiatsagul Tanyatuth, Moss Heather E
Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Ann Eye Sci. 2020 Mar;5. doi: 10.21037/aes.2019.12.06. Epub 2020 Mar 15.
Idiopathic intracranial hypertension (IIH) is a condition in which elevated pressure in the cerebrospinal fluid can lead to optic nerve head (ONH) dysfunction and subsequent visual impairment. Physicians are currently limited in their ability to monitor and manage this condition, as clinical symptoms and exam findings are often delayed in response to changes in intracranial pressure. In order to find other biomarkers of disease, researchers are using imaging modalities such as optical coherence tomography (OCT) to observe microscopic changes in the eye in this condition. OCT can create 2-dimensional and 3-dimensional high definition images of the retina of the ONH and has been used to study various conditions such as glaucoma and multiple sclerosis. Numerous studies have used OCT in IIH as well, and they have shown that certain retinal layers and the ONH change in thickness and shape in both the short and long term with intracranial pressure changes. OCT is a promising modality for clinical and scientific evaluation of IIH as it is a noninvasive and practical tool to obtain in depth images. This review will discuss how OCT can be used to assess a patient with IIH, both before and after treatment, along with its limitations and future applications.
特发性颅内高压(IIH)是一种脑脊液压力升高可导致视神经乳头(ONH)功能障碍及随后视力损害的病症。目前医生在监测和管理这种病症方面能力有限,因为临床症状和检查结果对颅内压变化的反应往往滞后。为了找到其他疾病生物标志物,研究人员正在使用光学相干断层扫描(OCT)等成像方式来观察这种病症下眼睛的微观变化。OCT可以创建ONH视网膜的二维和三维高清图像,并已用于研究青光眼和多发性硬化症等各种病症。许多研究也在IIH中使用了OCT,并且这些研究表明,随着颅内压变化,某些视网膜层和ONH的厚度和形状在短期和长期都会发生变化。OCT是一种用于IIH临床和科学评估的有前景的方式,因为它是一种获取深度图像的非侵入性实用工具。本综述将讨论OCT如何用于评估IIH患者治疗前后的情况,以及其局限性和未来应用。