Optical coherence tomography of the retinal nerve fibre layer in mild papilloedema and pseudopapilloedema

E. Z. Karam, Thomas R. Hedges

Research output: Contribution to journalArticlepeer-review

105 Scopus citations


Aims: To determine the degree to which optical coherence tomography (OCT) can distinguish differences in retinal nerve fibre layer (RNFL) thickness between eyes with mild papilloedema, pseudopapilloedema, and normal findings. Methods: 13 patients with mild papilloedema, 11 patients with congenitally crowded optic nerves, and 17 normal subjects underwent neuro-ophthalmic examination, automated visual field testing, and fundus photography. Spinal fluid pressure measurements were obtained in a subgroup of five patients with pseudopapilloedema and 11 patients with mild papilloedema. Circular OCT scans using a diameter of 3.38 mm surrounding the optic disc were performed in each eye of patients and subjects. Fundus photographs were analysed by two observers who diagnosed crowding or papilloedema and graded amounts of swelling. Findings were assessed by descriptive statistics and variance analysis. Results: RNFL thickness was greater in me superior and inferior quadrants and showed a high degree of correlation between each group of patients and subjects. A statistically significant difference was found in mean RNFL thickness between both groups of patients with optic disc swelling and normal subjects. However, there was not a statistical difference in mean nerve fibre layer thickness between patients with papilloedema and those with congenitally crowded optic nerves. Conclusions: OCT demonstrates measurable differences in nerve fibre layer thickness between normal subjects and patients with either papilloedema or pseudopapilloedema. However, OCT does not appear to differentiate between those individuals with congenitally crowded optic nerves and those with mild papilloedema caused by increased intracranial pressure.

Original languageEnglish (US)
Pages (from-to)294-298
Number of pages5
JournalBritish Journal of Ophthalmology
Issue number3
StatePublished - Mar 2005
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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