J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website http://www.neurores.org

Original Article

Volume 9, Number 4-5, October 2019, pages 65-71

The Association of Optical Coherence Tomography Results With Neuroimaging Signs and Some Clinical Parameters in Idiopathic Intracranial Hypertension

Figure 1. Graphic analysis demonstrating the correlation between LP opening pressure and average RNFL thickness of the right eye. LP: lumbar puncture; RNFL: retinal nerve fiber layer.

Figure 2. Images from the patients with IIH. (a) Empty sella. (b) Increased perioptic CSF. (c) Optic nerve tortuosity. (d) Optic nerve head protrusion (arrows). IIH: idiopathic intracranial hypertension; CSF: cerebrospinal fluid.

**Table 1.** Clinical Features of the Patients
N = 18 (F/M = 17:1)	Mean ± SD	Minimum	Maximum
F: female; M: male; SD: standard deviation; BMI: body mass index; LP: lumbar puncture; MRI: magnetic resonance imaging; RNFL: retinal nerve fiber layer.
Age	38.6 ± 14.9	19	69
BMI	30.5 ± 5.7	20.3	39.5
LP opening pressure (mm H₂O)	313.8 ± 66.6	230.0	440.0
Total MRI score	2.5 ± 1.2	0.0	5.0
Average RNFL thickness (right/µm)	113.8 ± 52.9	75.0	316.0
Average RNFL thickness (left/µm)	111.3 ± 47.2	77.0	284.0

Table 1. Clinical Features of the Patients

N = 18 (F/M = 17:1)

Mean ± SD

Minimum

Maximum

F: female; M: male; SD: standard deviation; BMI: body mass index; LP: lumbar puncture; MRI: magnetic resonance imaging; RNFL: retinal nerve fiber layer.

Age

38.6 ± 14.9

BMI

30.5 ± 5.7

20.3

39.5

LP opening pressure (mm H₂O)

313.8 ± 66.6

230.0

440.0

Total MRI score

2.5 ± 1.2

0.0

5.0

Average RNFL thickness (right/µm)

113.8 ± 52.9

75.0

316.0

Average RNFL thickness (left/µm)

111.3 ± 47.2

77.0

284.0

**Table 2.** Correlation Analyses Between OCT and MRI Measurements and Some Clinical Features
Correlations	R value	P value
*Correlation is significant at the 0.05 level (two-tailed). OCT: optical coherence tomography; MRI: magnetic resonance imaging; RNFL: retinal nerve fiber layer; LP: lumbar puncture; BMI: body mass index.
Total MRI score - RNFL (mean)	0.275	0.269
Total MRI score - average RNFL-right	0.150	0.554
Total MRI score - average RNFL-left	0.157	0.535
LP opening pressure - RNFL (mean)	0.427	0.077
LP opening pressure - average RNFL-right	0.470*	0.049*
LP opening pressure - average RNFL-left	0.440	0.067
BMI - RNFL (mean)	0.002	0.993
BMI - average RNFL-right	-0.023	0.928
BMI - average RNFL-left	-0.018	0.944
Total MRI score - LP opening pressure	0.032	0.900
Total MRI - BMI	0.184	0.464
LP opening pressure - BMI	0.063	0.803

Table 2. Correlation Analyses Between OCT and MRI Measurements and Some Clinical Features

Correlations

R value

P value

*Correlation is significant at the 0.05 level (two-tailed). OCT: optical coherence tomography; MRI: magnetic resonance imaging; RNFL: retinal nerve fiber layer; LP: lumbar puncture; BMI: body mass index.

Total MRI score - RNFL (mean)

0.275

0.269

Total MRI score - average RNFL-right

0.150

0.554

Total MRI score - average RNFL-left

0.157

0.535

LP opening pressure - RNFL (mean)

0.427

0.077

LP opening pressure - average RNFL-right

0.470*

0.049*

LP opening pressure - average RNFL-left

0.440

0.067

BMI - RNFL (mean)

0.002

0.993

BMI - average RNFL-right

-0.023

0.928

BMI - average RNFL-left

-0.018

0.944

Total MRI score - LP opening pressure

0.032

0.900

Total MRI - BMI

0.184

0.464

LP opening pressure - BMI

0.063

0.803

**Table 3.** T-Test Comparing the Clinical, MRI and OCT Measurements Between Patient Groups Categorized According to Cut-Off LP Opening Pressure of 300 mm H₂O (Levene’ s Test)
LP opening pressure (mm H₂O)	N	Mean	SD	P value
*BMI values were higher in the patient group with higher LP opening pressure values. MRI: magnetic resonance imaging; OCT: optical coherence tomography; LP: lumbar puncture; RNFL: retinal nerve fiber layer; BMI: body mass index; SD: standard deviation.
Average RNFL-right
< 300	10	98.0	16.5	0.079
≥ 300	8	133.7	75.0
Average RNFL-left
< 300	10	98.2	18.1	0.070
≥ 300	8	127.7	66.6
RNFL-mean
< 300	10	103.1	23.9	0.176
≥ 300	8	132.0	69.7
BMI
< 300	10	29.3	4.1	0.046*
≥ 300	8	31.9	7.2
Total MRI score
< 300	10	2.4	1.5	0.433
≥ 300	8	2.6	0.9

Table 3. T-Test Comparing the Clinical, MRI and OCT Measurements Between Patient Groups Categorized According to Cut-Off LP Opening Pressure of 300 mm H₂O (Levene’ s Test)

LP opening pressure (mm H₂O)

Mean

P value

*BMI values were higher in the patient group with higher LP opening pressure values. MRI: magnetic resonance imaging; OCT: optical coherence tomography; LP: lumbar puncture; RNFL: retinal nerve fiber layer; BMI: body mass index; SD: standard deviation.

Average RNFL-right

< 300

98.0

16.5

0.079

≥ 300

133.7

75.0

Average RNFL-left

< 300

98.2

18.1

0.070

≥ 300

127.7

66.6

RNFL-mean

< 300

103.1

23.9

0.176

≥ 300

132.0

69.7

BMI

< 300

29.3

4.1

0.046*

≥ 300

31.9

7.2

Total MRI score

< 300

2.4

1.5

0.433

≥ 300

2.6

0.9

**Table 4.** T-Test Comparing the Clinical, MRI and OCT Measurements Between Patient Groups Categorized According to Cut-Off LP Opening Pressure of 400 mm H₂O (Levene’s Test)
LP opening pressure (mm H₂O)	N	Mean	SD	P value
*RNFL measurements were significantly higher in the patient group with LP opening pressure higher than 400 mm H₂O. MRI: magnetic resonance imaging; OCT: optical coherence tomography; LP: lumbar puncture; RNFL: retinal nerve fiber layer; BMI: body mass index; SD: standard deviation.
Average RNFL-right
< 400	15	101.8	17.6	0.000*
≥ 400	3	174.3	122.6
Average RNFL-left
< 400	15	101.2	20.9	0.000*
≥ 400	3	161.6	106.3
RNFL-mean
< 400	15	105.5	22.3	0.000*
≥ 400	3	168.0	114.4
BMI
< 400	15	30.5	5.1	0.226
≥ 400	3	30.3	9.6
Total MRI score
< 400	15	2.4	1.3	0.268
≥ 400	3	2.6	0.5

Table 4. T-Test Comparing the Clinical, MRI and OCT Measurements Between Patient Groups Categorized According to Cut-Off LP Opening Pressure of 400 mm H₂O (Levene’s Test)

LP opening pressure (mm H₂O)

Mean

P value

*RNFL measurements were significantly higher in the patient group with LP opening pressure higher than 400 mm H₂O. MRI: magnetic resonance imaging; OCT: optical coherence tomography; LP: lumbar puncture; RNFL: retinal nerve fiber layer; BMI: body mass index; SD: standard deviation.

Average RNFL-right

< 400

101.8

17.6

0.000*

≥ 400

174.3

122.6

Average RNFL-left

< 400

101.2

20.9

0.000*

≥ 400

161.6

106.3

RNFL-mean

< 400

105.5

22.3

0.000*

≥ 400

168.0

114.4

BMI

< 400

30.5

5.1

0.226

≥ 400

30.3

9.6

Total MRI score

< 400

2.4

1.3

0.268

≥ 400

2.6

0.5

**Table 5.** Frequencies of the MRI Signs of Intracranial Hypertension in Our Patient Group
	N	%
MRI: magnetic resonance imaging; CSF: cerebrospinal fluid.
Optik nerve head protrusion
(+)	2	11%
(-)	16
Posterior scleral flattening
(+)	8	44%
(-)	10
Increased perioptic CSF
(+)	15	83%
(-)	3
Optik nerve tortuosity
(+)	9	50%
(-)	9
Empty partial empty sella
(+)	7	39%
(-)	11
Tonsillar herniation
(+)	0	0%
(-)	18
Enlargement of Meckel’s cave
(+)	4	22%
(-)	14
Meningoceles
(+)	0	0%
(-)	18

Table 5. Frequencies of the MRI Signs of Intracranial Hypertension in Our Patient Group

MRI: magnetic resonance imaging; CSF: cerebrospinal fluid.

Optik nerve head protrusion

(+)

11%

(-)

Posterior scleral flattening

(+)

44%

(-)

Increased perioptic CSF

(+)

83%

(-)

Optik nerve tortuosity

(+)

50%

(-)

Empty partial empty sella

(+)

39%

(-)

Tonsillar herniation

(+)

(-)

Enlargement of Meckel’s cave

(+)

22%

(-)

Meningoceles

(+)

(-)