Clinical profile and retinal nerve fibre layer thickness of optic disc oedema patients at a tertiary care institute in North India.

Abstract

Background: Optic disc oedema (ODE) is an important manifestation in various ocular as well as systemic disorders. Measurement of retinal nerve fibre layer (RNFL) thickness in ODE patients may help in monitoring the progress of the disease and treatment response.

Objective: To assess the clinical characteristics, aetiology and retinal nerve fibre layer (RNFL) imaging features of optic disc oedema (ODE) patients.

Design: A retrospective observational study.

Methods: This hospital-based study included performed for patients presenting with unilateral or bilateral ODE at the ophthalmology outpatient department of a tertiary institute between January 2019 and December 2019. Clinical features of all ODE patients were noted. RNFL thickness was measured by spectral-domain optical coherence tomography (Cirrus 500, Carl Zeiss Meditec, Dublin, CA, USA).

Results: Sixty-four patients with ODE were seen with female preponderance (56.2%). The mean age of presentation was 36.8 ± 13.8 years. Bilateral ODE was seen in 57.8% patients. The most common cause of bilateral ODE was idiopathic intracranial hypertension (IIH) and vascular papillopathy. Retinal vein occlusion (RVO)-associated ODE was the most common unilateral presentation. Presenting visual acuity was best with IIH and worst with anterior ischaemic optic neuropathy (AION). The mean duration of symptoms was maximum with intracranial space-occupying lesion associated papilloedema and minimum with AION. The mean RNFL thickness was highest in uveitis-associated ODE, followed by compressive ON, and IIH. A positive correlation was noted between clinical ODE severity and RNFL thickness. All aetiological categories (except uveitic and compressive) had maximum RNFL thickening in the inferior quadrant and minimum in the temporal quadrant.

Conclusion: The current study provides a clinical profile and RNFL measurements of ODE patients at this locality. The clinical severity of ODE correlated positively with RNFL thickness and most of the categories of ODE followed the normative pattern of RNFL thickness (inferior > superior > nasal > temporal) despite thickening.