Optical coherence tomography as an adjunct tool to assess response to treatment in cerebral venous thrombosis: A prospective longitudinal study

Abstract

Introduction: Papilledema, due to raised intracranial pressure (ICP) is commonly seen in cerebral venous thrombosis (CVT) and can have serious complications. This study reports the quantitative assessment of papilledema through the measurement of the Peripapillary choroidal thickness (ChT) and Peripapillary retinal nerve fiber layer thickness (RNFLT) using optical coherence tomography (OCT).

Methods: We conducted a prospective longitudinal study of 30 subjects with CVT. Age and gender-matched healthy individuals were included as controls. In addition to history, RNFLT and ChT measurements were obtained at presentation, discharge, and follow-up two months after discharge.

Results: The mean age of the patients was 32.8 ± 9.9 years. Papilledema was seen in 14 (46.66 %) patients. The peripapillary RNFLT and ChT were significantly greater in patients with CVT [RNFLT 121.5 μm (105,169) in the right eye (RE), 120 μm (103,148) in the left eye (LE); ChT 159 μm (143,171) in the RE, 155.5 μm (140,166) in the LE] as compared to controls [RNFLT 106.5 μm (102,111) in RE, 103.5 μm (98,107) in LE; ChT 130 μm (119,134) in RE, 124 μm (119,136) in LE]. There was a significant decrease in the peripapillary RNFLT and ChT in patients with papilledema at follow-up after two months in all segments in both eyes.

Conclusion: In patients with CVT, RNFLT, and ChT reduced significantly with treatment. OCT is potentially useful to objectively assess response to treatment in patients with CVT.

Keywords: Cerebral venous thrombosis; Choroid; Optical coherence tomography; Retinal nerve fiber layer.