Optical coherence tomography confirms shunt malfunction and recurrence of raised intracranial pressure in optic atrophy.

Qureshi, Ahoane, Virdee, Jasvir, Tsermoulas, Georgios, Sinclair, Alex J and Mollan, Susan P (2020) Optical coherence tomography confirms shunt malfunction and recurrence of raised intracranial pressure in optic atrophy. British journal of neurosurgery. pp. 1-7. ISSN 1360-046X. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: http://informahealthcare.com/journal/bjn/

Abstract

BACKGROUND

Investigating potential cerebrospinal fluid (CSF) shunt malfunction can be a challenge. Optical coherence tomography (OCT), a non-invasive imaging technique, is used to monitor changes at the optic nerve head in papilloedema. Conventional teaching suggests that in the presence of optic atrophy the optic nerve head may not re-swell in response to a relapse in raised intracranial pressure (ICP).

METHODS

A retrospective case series of three patients who had prior CSF diversion surgery for idiopathic intracranial cranial hypertension (IIH) is presented demonstrating the benefit of non-invasive OCT imaging confirming raised ICP.

RESULTS

Recurrence of raised ICP, due to malfunctioning CSF shunt, was diagnosed in three patients requiring further surgical intervention. All re-presented acutely with headache and visual disturbances. All had a prior diagnosis of optic atrophy. In all patients, OCT peripapillary retinal nerve fibre layer qualitative image analysis and quantified progression analysis permitted easy detection of the recurrence of papilloedema.

CONCLUSION

OCT imaging supports clinical decision making in shunt malfunction, even in the presence of established optic atrophy secondary to IIH.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WL Nervous system. Neurology
WN Medical imaging. Radiology
WW Eyes. Ophthalmology
Divisions: Emergency Services > Neurology
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 23 Nov 2020 11:17
Last Modified: 17 Feb 2021 10:33
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3702

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