HomeAnswersOphthalmology (Eye Care)bilateral papilledemaIs OCT scan reliable in detecting pseudo-papilledema?

OCT scan for pseudo-papilledema shows dilution. Is it possible for the dilution to be fake?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At December 24, 2019
Reviewed AtJuly 23, 2023

Patient's Query

Hello doctor,

I did an OCT scan for the first time last week, but it appears that the sup / nas is slightly diluted. Well, I was born with an optic nerve abnormality they call it pseudo-papilledema. I was born with high hyperopia en strabismus (high hyperopia may be associated with blurring of the optic disk margin) thats it. My question is, is it possible that this dilution is fake? Or is it possible that the OCT is not working properly in my eyes?

Hello,

Welcome to icliniq.com.

I have gone through the OCT (optic coherence tomography) reports of your left eye. (attachment removed to proteect patient identity). I understand that you have been informed that you have pseudo papilloedema of your left eye. Let me explain to you in very simple words what pseudo papilloedema means and what an OCT actually does. The term "pseudo" papilloedema, as the name suggests is an appearance of false swelling of the optic disc. Here even though the disc is normal it appears to be swollen and hence named so. An OCT is an imaging modality, it simply can image a structure (in the eye) and tell us exact measurements of its heights, extent, cellular number, etc. It does so by comparing age and race matched set of control data to your eye. (Indicated by the black colored dotted line on the right-hand side of the black & white retina image). Most of this line in your eye falls well within the normal range (green background) so it is reasonably normal. It is however not able to measure function or how well the eye/ that structure is performing. To further simplify, your eyes do not have any true problem with the optic nerve. Secondly, a functional assessment of the nerves cannot be done using an OCT. In case you feel that you would like to have further tests done, I would like to advise you regarding getting a check of your intraocular pressure and visual field tests along with regular eye tests. I personally feel that as long as you do not have any symptoms, do not have anyone in the family with glaucoma and hypermetropia less than three, there is no further need to be worried about this.

Patient's Query

Thank you doctor,

My ophthalmologist says that the decrease that is a bit in sup / nas is due to my high hyperopia and the pseudo papilledema in the optic nerves. Because of that, I get no measurements like in normal people. Is this correct? The OCT is also different every time, a little higher and then a little lower.

Hello,

Welcome back to icliniq.com.

Yes, I agree with what your ophthalmologist said and it is the same explanation as I gave you regarding your condition in my previous reply. I would again like to reassure you that it is not a cause for concern, but in case you want to get it checked, then the best option is to get a visual field test or perimetry. I hope this helps.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Manjunath Natarajan
Dr. Manjunath Natarajan

Ophthalmology (Eye Care)

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