Anmeldung zur Tagung
Registration
Grußwort
Invitation
Themen
Topics
Allgemeiner Ablauf
General overview
Wissenschaftliches Programm
Scientific program
Kurse
Courses
Symposien
Symposiums
Frühstück mit Spezialisten
Breakfast with specialists
Arzthelferinnen-Fortbildung
Rahmenprogramm
Social program
DOG Information
DOG Information
Allgemeine Informationen
General Information
Autorenindex
Index of Authors
Ausstellerliste
Exhibitors
Sponsoren
Sponsors
Teilnahmegebühren
Registration fees
Impressum
Correlation of cerebrospinal fluid pressure with measurements with the HRT in pseudotoumor cerebri
Mardin C., Jünemann A., Heckmann J.
Universitätsaugenklinik mit Poliklinik Erlangen, Schwabachanlage 6, 91054 Erlangen
Objective: It was the aim of this prospective study to investigate
the correlation of measurements of laser-scanning-tomography of the optic
disc with the cerebrospinal fluid pressure (csfp) in patients with pseudotumor
cerebri (pc) in the course of the disease.
Methods: 32 eyes of 16 patients with bilateral and one eye of one
patient with unilateral papilledema and pc (4m, 13w; OD 16, OS 17) have
been examined since 1997 repeatedly. Apart from the history and neurologic
examination, visual acuity and visual field (Goldmann) measurements were
obtained and ophthalmoscopy performed. The course of papilledema was investigated
with 15°-fundus stereographs and the HRT I(Heidelberg Engineering,
Dossenheim, Software-Version 2.01. Reliability of the reference plane
was determined by repeated measurements of five days with five optic discs.
The contourline was extrapolated on the reflectance image and reimported
into the follow-up measurements. Using 15°- and 20° images following
variables were calculated: rim volume (RV, volume above reference) and
mean height of contour (MHC) globally and in four sectors. Csfp was measured
immediately before the HRTmeasurement in the supine position (cmH2O).
Results: Time of follow-up ranged from 1-48 months. Visual acuity
was 1,0±0,19, Goldmann perimetry showed a enlarged blind spot in
all the eyes before therapy. Only one patient showed a circuferrential
narrowing of the visual field. Therapy of pc was 17x repeated lumbar puncture,
15x sys. acetazolamid, 1x steroids and 1x lumbo-peritoneal shunt. Reliability
of the reference plane was 99,9% . MHC was independent of the reference
plane. The variability of the disc area was 0,04±0,03mm² (0-0,13mm²).
Decreasing RV and MHC correlated significantly with decreasing csfp (R=0,6;
p=0,0001). RV and MHC were highest nasally (0,66±0,34mm³ /0,77±0,25mm),
followed by the upper (0,47±0,25mm³/0,72±0,24mm), lower
(0,46±0,23mm³/0,70±0,22mm) and temporal (0,24±0,16mm³/0,44±0,30mm)
sector.
Conclusion: HRT allows an exact follow-up examination of RV and MHC with
a high reliability. The measurements with the HRT correlate significantly
with the csfp. Supported by SFB 539