Oral Fluorescein Angiography for the Diagnosis of Papilledema Versus Pseudopapilledema in Children.

Autor: Elhusseiny AM; From the Department of Ophthalmology (A.M.E., J.W.F., C.H., F.G., A.P.G., A.B.S., S.H.U., P.H.P.), Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Fong JW; From the Department of Ophthalmology (A.M.E., J.W.F., C.H., F.G., A.P.G., A.B.S., S.H.U., P.H.P.), Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and the Department of Ophthalmology (J.W.F., M.K.S.), Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee, USA., Hsu C; From the Department of Ophthalmology (A.M.E., J.W.F., C.H., F.G., A.P.G., A.B.S., S.H.U., P.H.P.), Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Grigorian F; From the Department of Ophthalmology (A.M.E., J.W.F., C.H., F.G., A.P.G., A.B.S., S.H.U., P.H.P.), Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Grigorian AP; From the Department of Ophthalmology (A.M.E., J.W.F., C.H., F.G., A.P.G., A.B.S., S.H.U., P.H.P.), Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Soliman MK; and the Department of Ophthalmology (J.W.F., M.K.S.), Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee, USA., Sallam AB; From the Department of Ophthalmology (A.M.E., J.W.F., C.H., F.G., A.P.G., A.B.S., S.H.U., P.H.P.), Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Uwaydat SH; From the Department of Ophthalmology (A.M.E., J.W.F., C.H., F.G., A.P.G., A.B.S., S.H.U., P.H.P.), Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Phillips PH; From the Department of Ophthalmology (A.M.E., J.W.F., C.H., F.G., A.P.G., A.B.S., S.H.U., P.H.P.), Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Electronic address: PhillipsPaulH@uams.edu.
Jazyk: angličtina
Zdroj: American journal of ophthalmology [Am J Ophthalmol] 2023 Jan; Vol. 245, pp. 8-13. Date of Electronic Publication: 2022 Sep 06.
DOI: 10.1016/j.ajo.2022.08.020
Abstrakt: Purpose: To evaluate the accuracy and safety of oral fluorescein angiography (OFA) in differentiating papilledema from pseudopapilledema in pediatric patients.
Design: Retrospective evaluation of a diagnostic test.
Methods: We retrospectively reviewed medical records of all children ≤18 years of age who presented to the Arkansas Children's Hospital between May 2018 and August 2021 with suspected optic disc (OD) swelling that had OFA and images >30 minutes after oral ingestion. Two masked specialists interpreted the images as either OD leakage, no leakage, or borderline leakage. Optic disc swelling was graded clinically according to the Frisen grading scale (0-5). We compared OFA images to the final clinical diagnosis and calculated the accuracy of the test as follows: (number of eyes correctly identified as papilledema [true positive] + number of eyes correctly identified as pseudopapilledema [true negative]) / (total number of eyes) × 100%.
Results: Forty-five patients (90 eyes) were included, 11 patients with papilledema and 34 with pseudopapilledema. The mean age was 14.1 ± 3.5 years; 66.7% were female. The accuracy of OFA was 62% for reviewer 1 and 69% for reviewer 2. No ocular or systemic side effects after OFA were observed. There was substantial agreement (k = 0.779) between both reviewers in grading the OFA images.
Conclusion: OFA cannot definitively distinguish papilledema from pseudopapilledema in children and should be interpreted in conjunction with other clinical findings.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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