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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 71 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 72 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). |