A bstract Introduction: Optic disc edema can arise from conditions such as increased intracranial pressure (ICT), anterior ischemic optic neuropathy (AION), papillitis, optic nerve head drusen, and malignant hypertension. Differentiating true edema from pseudopapilledema and determining its cause is crucial for effective management. This study evaluates optical coherence tomography (OCT), a noninvasive imaging tool, and measures retinal nerve fiber layer (RNFL) thickness. This study evaluates OCT’s ability to distinguish causes of optic disc edema by assessing quadrant-specific RNFL thickness. Materials and Methods: In this prospective study (July 2017–August 2019), data from 123 eyes of 70 patients with optic disc edema due to raised ICT, AION, papillitis, or malignant hypertension were analyzed. Patients with hypermetropia (>+5D) or media opacities were excluded from the study. RNFL thickness in four quadrants was measured using Zeiss Cirrus HD-OCT 4000. Statistical analyses were performed using Kruskal–Wallis and Mann–Whitney tests, with Bonferroni adjustments for P value. Results: AION had the highest RNFL thickness (212.4 μm), followed by malignant hypertension (180.6 m), ICT (163 μm), and papillitis (144.2 μm). Statistically significant differences were observed in nasal ( P = 0.04) and temporal ( P = 0.01) RNFL thicknesses, while superior and inferior quadrants showed no significant variation. Discussion: Quadrant-specific RNFL measurements, particularly in the nasal and temporal quadrants, proved useful in differentiating causes of optic disc edema. However, overall RNFL thickness alone was not sufficient for reliable differentiation. Conclusion: OCT is a promising noninvasive tool for evaluating optic disc edema. Nasal and temporal RNFL thicknesses offer significant diagnostic insights, but larger studies are needed to improve diagnostic accuracy.
Kashyap et al. (Mon,) studied this question.