Edited Film

Hamid Sajjadi, USA

Purpose:
To show that using 3D OCT of optic nerve head the posterior orbital or brain aspect of the nerve head shows changes compatible with high ICP.

Methods:
On over 15 years and 5000 3D OCTs done we found 332 patients with high intracranial pressure proven by MRI and or LP; we have noticed on 3D optic nerve head OCT, a large (over 120 degrees) posterior rim changes that were associated with cases of increased intracranial pressure. The changes were the same in Pseudotumor Cerebri or tumors large enough to cause increased intracranial pressure. In non-increased intracranial pressure patients no significant (more than 90 degrees) of cupping nor erosion was seen.

These consisted of 2 type changes,

  1. Inward cupping or reverse cupping of the optic nerve at orbital entrance into the globe.
  2. Posterior rim erosion from the edge of optic nerve exit into the orbit.

The only way to show these changes was presentation by video, because in the 2D view of the posterior rim is difficult to discern these changes.

So we are presenting an 8 minute scientific video pointing to these findings.

Results:
Review of 332 cases consisting of 325 pseudotumor Cerebri and 7 real brain tumors showed posterior cupping and erosion of the optic nerve to show high intracranial pressure on MRIs and or lumbar punctures.

Conclusion:
3D imaging of the optic nerve by OCT, looking from the brain side, can show reverse cupping and erosion changes that were very specifically signs of increased intracranial pressure.

Contact Details:

 

Hamid Sajjadi, MD, FACS
San Jose Eye and Laser Medical Center
Phone: +1 408 402 5867 and if not answer call +1 408 390 8825
Email: hsajjadi@yahoo.com