Optical coherence tomography and optic nerve edema

Abstract

Optical coherence tomography (OCT) continues to advance our understanding of the various diseases characterized by optic disc edema. In acute papilledema, OCT has demonstrated subretinal fl uid extending from the optic disc to the subfoveal region, assisting in our understanding of the pathophysiology of vision loss in these cases. In evolving cases of optic disc edema, OCT of the RNFL can thus be an objective measurement of nerve swelling. By analyzing the ganglion cell complex, OCT can now help detect early axonal damage in optic nerve disease, even when the RNFL is edematous, and may be helpful in predicting visual outcomes. Finally, OCT has also proven to be a reliable tool in assisting clinicians in differentiating between cases of frank papilledema and pseudopapilledema, such that occurs in optic nerve head drusen, vitreopapillary traction, Bergmeister papilla, and myelinated nerve fi ber layer.