Evaluation of CSF pressures, OCT parameters, and transorbital ultrasonographic measurements in ıdiopathic...

Idiopathic intracranial hypertension (IIH) is a condition characterized by increased intracranial pressure, predominantly seen in obese women. IIH presents with symptoms such as headache, vision loss, and papilledema, requiring early diagnosis and treatment. This study aimed to evaluate the diagnostic value of non-invasive methods, including transorbital ultrasonography (TOUS) and optical coherence tomography (OCT), by measuring parameters such as optic nerve sheath diameter (ONSD) and retinal nerve fiber layer thickness (RNFLT) in IIH diagnosis.

The study included 31 patients diagnosed with IIH (29 women, 2 men) and 31 healthy controls.Query ONSD measurements were performed using TOUS before and after lumbar puncture (LP) in patients. Additionally, OCT was used to measure RNFLT, ganglion cell complex (GCC), and retinal thickness. Statistical analysis was conducted using the Mann-Whitney U test, ROC curve, and correlation analyses.

The ONSD measurements in the patient group were significantly higher compared to the control group (p < 0.001). A marked decrease in ONSD was observed post-LP (p < 0.001). OCT measurements showed that RNFLT was significantly thicker in the patient group compared to controls (p < 0.001). In patients with papilledema, RNFLT was higher than in those without papilledema. A moderate positive correlation was found between ONSD and RNFLT (R = 0.59, p < 0.001).

ONSD measured by TOUS and RNFLT assessed by OCT are reliable non-invasive methods for diagnosing IIH. These techniques can reduce the need for invasive procedures like LP, enhancing patient comfort. Our study contributes to the literature by providing cut-off values for ONSD and RNFLT and supports their effectiveness in early IIH diagnosis. Validation of these findings through future studies with larger patient groups is essential.