Optical coherence tomography of the swollen optic nerve head: deformation of the peripapillary RPE layer in papilledema

Purpose: To examine the biomechanical deformation of load bearing structures of the optic nerve head (ONH) resulting from raised intracranial pressure, using high definition optical coherence tomography (HD-OCT). We postulate that elevated intracranial pressure induces forces in the retrolaminar subarachnoid space that can deform ONH structures, particularly the peripapillary Bruch's membrane (BM) and retinal pigment epithelium (RPE) layers. Methods: We compared HD-OCT optic nerve and peripapillary retinal nerve fiber layer (RNFL) findings in eyes with papilledema due to raised intracranial pressure to findings in eyes with optic disc swelling due to optic neuritis and non-arteritic anterior ischemic optic neuropathy ...
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