A pale disc is characteristic of long-standing optic neuropathy. On clinical examination, the optic nerve head appears edematous in early stages. The main symptoms are a decrease of visual acuity (VA) and the alteration of the color vision, with colors appearing subtly washed out in the affected eye. Damage and death of these neurons leads to characteristic features of optic neuropathy. Optic neuropathy refers to damage to the optic nerve due to multiple causes. Multiple studies and clinical observations support the importance of optical coherence tomography in the diagnosis, treatment, and follow-up of optic neuropathies.Ībbreviations: OCT = optical coherence tomography, VA = visual acuity, RNFL = retinal nerve fiber layer, GCL = ganglion cells layer, MS = multiple sclerosis, ON = optic neuropathy, NAION = non-arteritic ischemic anterior optic neuropathy, LHON = Leber hereditary optic neuropathy, RE = right eye, LE = left eye Furthermore, optical coherence tomography is useful in patients with multiple sclerosis in distinguishing macular disease from optic neuritis and in monitoring the treatment. It can be useful for diagnosis and follow-up of optic nerve and chiasmal compressive diseases. By analyzing the ganglion cell complex, optical coherence tomography can help detect early axonal damage and may predict the visual outcome. The measurements of retinal nerve fiber layer can be an objective measurement of nerve swelling or nerve atrophy. Optical coherence tomography offers the opportunity to study neurological diseases in an objective and non-invasive manner. Optical coherence tomography performs in vivo, real-time, noncontact scanning and provides cross-sectional and volumetric images with a resolution approaching that of histology. Optical coherence tomography has been one of the most important innovations in ophthalmology, which offered the possibility to analyze specific structures of the retina. This technology may help guide decisions about the appropriate type and timing of surgical treatment.Ĭopyright © 2022 by the American Society of Plastic Surgeons.Optical neuropathies are neuro-ophthalmologic disorders, the main symptoms of which are the decrease of visual acuity and the alteration of the color vision. Spectral-domain optical coherence tomography can noninvasively detect elevated intracranial pressure in patients with craniosynostosis with reliable sensitivity and specificity. Patients with associated syndromes or multiple suture involvement and patients aged 9 months or older were significantly more likely to have elevated intracranial pressure above 15 mmHg (p ≤ 0.030) and above 20 mmHg (p ≤ 0.035). Patients with maximal retinal nerve fiber layer thickness and maximal anterior projection exceeding set thresholds in optical coherence tomography of either eye demonstrated 77.3 percent sensitivity and 95.0 percent specificity for detecting intracranial pressure above 15 mmHg, and 90.0 percent sensitivity and 81.3 percent specificity for detecting intracranial pressure above 20 mmHg. Maximal retinal nerve fiber layer thickness, maximal retinal thickness, and maximal anterior projection optical coherence tomographic parameters were positively correlated with intracranial pressure (p ≤ 0.001), with all parameters showing significantly higher values in patients with intracranial pressure thresholds of 15 mmHg (p < 0.001) and 20 mmHg (p ≤ 0.007). Optical coherence tomography was performed in 158 subjects, among which 42 underwent direct intracranial pressure measurement during an initial cranial procedure. Optical coherence tomographic parameters were compared to directly measured intracranial pressure and used for pattern assessment. Intracranial pressure was directly measured intraoperatively in a subset of cases. Pediatric patients with craniosynostosis undergoing surgical intervention between 20 prospectively underwent optical coherence tomographic evaluation. Spectral-domain optical coherence tomography may enable noninvasive assessment of intracranial pressure in pediatric patients with craniosynostosis. However, accurately measuring intracranial pressure is challenging, and patterns in craniosynostosis patients are poorly characterized. Craniosynostosis may lead to elevated intracranial pressure, which may be implicated with impaired neurocognitive development.
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