Optical coherence tomography in following up papilledema in idiopathic intracranial hypertension treated with lateral sinus stent placement

Objective - To quantify the course of papilledema using the OCT 3 Stratus (Carl Zeiss Meditec, Dublin, CA, USA) after lateral sinus stent placement in patients with idiopathic intracranial hypertension (IIH) Methods - Ten consecutive patients with a diagnosis of IIH underwent OCT examination before and after lateral sinus stenting, between March 2006 and April 2008, in Timone Hospital's Ophthalmology Department (Marseille France) All patients had criteria for IIH (International Headache Society, 2004) and sinus abnormalities were diagnosed using three dimensional rotational gadolinium enhanced MR venography In all cases, a direct retrograde cerebral venography with manometry was performed We used the Cord's PRECISE (R) RX Nitinol Stent system (ref 10136245 3, Johnson & Johnson), 30-40 mm in length and 8 mm in diameter, all placed by a single operator via a femoral venous puncture For each eye, the mean retinal nerve fiber layer thickness was noted using the RNFL Thickness (3 4) strategy, before stenting, and three times after stent placement The other parameters considered were age, sex, weight, height and body mass index Results - A significant decrease in retinal nerve fiber layer thickness was observed after stent placement This parameter was considered normal 3 months after stent placement for eight of ten patients Conclusion - Even though this pathology remains misunderstood, we observed a significant decrease in papilledema in IIH after lateral sinus stent placement, suggesting that high intra cranial venous pressure could play a role in this pathology (C) 2010 Elsevier Masson SAS All rights reserved