Diagnosis and Grading Of Papilledema Using Optical Coherence Tomography Compared To Clinical Staging By Frise´n Scale.

Document Type : Original research articles


Ophthalmology Department, Qena Faculty of Medicine, South Valley University.


Background:Papilledema, or optic disc swelling due to raised intracranial pressure, has been graded using the Frise´ n Scale.
Objectives: In this study we aim to compare and contrast 2 methods of quantitating papilledema, namely, Optical coherence tomography (OCT) and Modified Frise´n Scale (MFS).
Materials and method:This study was performed at ophthalmology department, Qena Faculty of Medicine, South Valley University from June 2019 to January 2020, thirty patients with papilledema were enrolled, assessment of OCT retinal nerve fiber layer thickness, OCT total retinal thickness, then compared by modified Frise´n scale from photographs. Results:Our study included 30 patients, 26 females with mean age 28.2±6.7 and 4 males with mean age 32±2, Among 30 patients with papilledema: 7(21) % had grade 1, 10(30) % had grade 2, 4(12) % had grade 3, 9(27) % had grade 4. When OCT RNFL thickness was compared with MFS grade from photographs (using majority rule), Spearman rank correlation was 0.727 (P<0.0005). When OCT total retinal thickness was compared with MFS grade from photographs, Spearman rank correlation was 0.789(P<0.0005).
Conclusions: In grading papilledema, we found strong correlation between the modified Frise´n scale and OCT findings. For lower-grade optic disc edema, OCT compares better with clinical staging of optic nerve head photographs. With higher grades of edema, OCT RNFL thickness processing algorithms often fail or lack sensitivity, while OCT total retinal thickness performing more favorably


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