Optical coherence tomography demonstrates subretinal macular edema from papilledema

Objective: To evaluate macular changes in eyes with papilledema from increa sed intracranial pressure using optical coherence tomography (OCT). Methods: Fifty-five patients with papilledema seen during 1998 and 1999 wer e studied with OCT of the optic nerve and retinal nerve fiber layer. Ninete en of these also had OCT of the macula during periods of acute, subacute, o r recurrent papilledema and were evaluated in detail for this report. Results: Seven patients had OCT evidence of subretinal fluid involving the macula. All had some reduction in visual acuity. The subretinal fluid appea red to arise from the peripapillary region, and all showed some improvement in central vision as the fluid resolved. Conclusions: Subretinal fluid accumulations can cause decreased visual acui ty in patients with papilledema. Optical coherence tomography can demonstra te subretinal fluid and can be used to follow the course of this important visual complication of papilledema.