الفهرس 
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Abstract
Papilledema is swelling of the optic nerve head due to elevated
intracranial pressure (ICP). This condition is associated with several
etiologies, including idiopathic intracranial hypertension (IIH).
Papilledema is evaluated clinically by fundoscopy and visual
inspection of the optic nerve head. Papilledema severity is assessed
based on the appearance of disc margin, height, and vascular visibility.
The Frisen scale has been developed to standardize papilledema
grading, but the clinical assessment of papilledema severity remains
subjective and often varies among observers.
Optical coherence tomography (OCT) is more accessible than
MRI and more commonly used to image the ocular region of the optic
nerve head mainly for assessing the retinal nerve fiber layer (RNFL).
OCT has been used to study pathological changes in papilledema and
the relation of these changes to papilledema severity, demonstrating
its potential as a more accurate measure of severity than an ordinal
measure such as the Frisen scale. Measurements of ONPL from OCT
had greater association with papilledema grade.
In addition, although OCT may have been expected to show a
greater association due to its higher resolution, the results depend on
an accurate characterization of papilledema severity using the Frisen
scale, a subjective grading system known to produce variation among
observers.
So, this study aimed to evaluate the relationship between optic
disc protrusion measured by OCT and papilledema severity by clinical
grading.
Summary
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To elucidate our aim, this study was carried out at the outpatient
clinic of ophthalmology department, faculty of medicine, Menoufia
University during the period study from January 2020 till March 2022.
A total of (60 eyes) 30 patients included in this study, their age
from (20 - 40) years old divided into, 15 patients (30 eyes) of
idiopathic increased intracranial hypertension (patients’ group) and 15
patients (30 eyes) of normal healthy control to assess reliability of
optic nerve protrusion length.
Inclusion criteria:
Both sexes with both eye ages 20-40 years
Patients of idiopathic increased intracranial pressure.
Exclusion criteria: Patient with history of:
Diabetic or hypertensive retinopathy.
Orbital diseases
Ocular inflammatory disease
Brain tumors.
Media opacity
All patients and healthy included in this study were subjected to the
following:
Detailed history taking including personal history as (name,
age, sex, residence, ...) and disease history.
Complete Ophthalmological examination included
Uncorrected visual acuity (UCVA), Best corrected visual acuity
(BCVA), Anterior segment detailed Slit Lamp examination,
Summary
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Posterior segment examination, For grading by Frisen scale,
Fundus photography for optic disc by fundus camera, and OCT
optic nerve imaging for ONPL measurement.
Results of the current study could be summarized as follows:
The most gender in the studied groups is female. While the age in
patient group was higher than control group (33.85 ± 5.94).
There was no statistically significant difference in BCVA (OS
and OD) regarding the studied groups.
ONPL OD, ONPL OS and Total ONPL were significantly
increased among patients’ group (847.7±180.2, 889.4±164.4,
868.6±172.3, respectively) than control group (190.8±29.90,
192.8±55.90, 191.8±42.90, respectively), (p<0.005).
Stage 2 and Stage 4 were the most in OD (33.33%) while, Stage 3
and Stage 5 were the most in OS (33.33%) regarding to Frisen
scale stages.
patients having stage 5 had significantly longer Optic nerve
protrusion length, followed by stage 4 than other Frisen scale
stages, with highly significant difference (p<0.001).
There was a positive relation between Frisen scale stages and
Optic nerve protrusion length. The highest Optic nerve protrusion
length was recorded (1033/1159) among patients with stage 5
followed by patients with stage 4 (887 /964) then stage 3 and 2.
While, the lowest Optic nerve protrusion length was obtained in
patients with stage 1 was recorded (300/500).