Evidence map›Paper›PMID 33469131›Full record

ArticleEye (London, England)2021

The sensitivity and specificity of retinal and choroidal folds to distinguish between mild papilloedema and pseudopapilledema.

Sara N Reggie, Robert A Avery, James C Bavinger, Imran Jivraj, Cesar Alfaro, Maxwell Pistilli, Anita A Kohli, Grant T Liu, Kenneth S Shindler, Ahmara G Ross and 3 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Eye (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Agreement and Accuracy of Papilledema and Pseudopapilledema Classification Among Pediatric Neuro-Ophthalmologists Using Optic Disc Photographs.Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society · 2025
    Observational
  3. Article
  4. Distinguishing Papilledema from Pseudopapilledema in Children.Advances in ophthalmology and optometry · 2024
    Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 2 countries.

Sara N ReggieDepartment of Ophthalmology, University of Tennessee Health Sciences Center, 930 Madison Ave #200, Memphis, TN, 38103, USA. snreggie@gmail.com.ORCID http://orcid.org/0000-0002-9764-2506
Robert A AveryDepartment of Neuro-ophthalmology, Departments of Ophthalmology and Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
James C BavingerDepartment of Neuro-ophthalmology, Departments of Ophthalmology and Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.ORCID http://orcid.org/0000-0002-2993-1277
Imran JivrajDepartment of Ophthalmology and Visual Sciences, University of Alberta, 2319 Active Treatment Centre, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3V9, Canada.
Cesar AlfaroDepartment of Ophthalmology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029-5674, USA.
Maxwell PistilliCenter for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, 3711 Market Street, Suite 801, Philadelphia, PA, 19103, USA.ORCID http://orcid.org/0000-0002-4266-4150
Anita A KohliDepartment of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, Suite 1B, New Haven, CT, 06510, USA.
Grant T LiuDepartment of Neuro-ophthalmology, Departments of Ophthalmology and Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Kenneth S ShindlerDepartment of Neuro-ophthalmology, Departments of Ophthalmology and Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Ahmara G RossDepartment of Neuro-ophthalmology, Departments of Ophthalmology and Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Randy H KardonDepartment of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, And Iowa City VA Healthcare System, 11290D PFP, Iowa City, IA, 52242, USA.
Patrick A SibonyDepartment of Ophthalmology, State University of New York at Stony Brook, University Hospital and Medical Center, Stony Brook, New York, 11794, USA.
Madhura TamhankarDepartment of Neuro-ophthalmology, Departments of Ophthalmology and Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
University of Pennsylvania · USChildren's Hospital of Philadelphia · USIcahn School of Medicine at Mount Sinai · USState University of New York · USUniversity of Alberta · CAUniversity of Iowa · USUniversity of Tennessee Health Science Center · USYale University · US

Funding

Scientific TransparencyP30EY001583 · NEI · UNIVERSITY OF PENNSYLVANIA · PI CLAIRE H MITCHELL · 1985 to 2026
$19.5M
Center for the Prevention and Treatment of Visual LossI50RX003002 · VA · IOWA CITY VA MEDICAL CENTER · PI RANDY H. KARDON, MARKUS H. KUEHN · 2019 to 2026
–
NEI NIH HHS P30 EY001583
6 · The paper itself

Abstract

purposeTo determine if the presence or absence of retinal and choroidal folds on SD-OCT imaging can distinguish between mild papilloedema and pseudopapilledema.

designCross-sectional cohort study

methodsSubjects with optic disc elevation (Frisen grades 1 and 2 only) were eligible to be enrolled prospectively. Pseudopapilledema was defined as a lack of change in optic disc appearance between two visits <6 months apart, and papilloedema was defined as change in optic disc appearance between two visits <6 months apart determined by review of fundus photographs by a masked neuro-ophthalmologist. Three masked neuro-ophthalmologists independently reviewed en face and axial optical coherence tomography (OCT) images of the optic nerve of the study subjects for the presence or absence of retinal and choroidal folds. Concordance was determined when there was agreement between at least 2 of the 3 observers.

resultsForty-five subjects (78 eyes) met inclusion criteria. There were 32 eyes with papilloedema and 46 eyes with pseudopapilledema. Choroidal and/or retinal folds were detected in 38% of eyes (12/32) with papilloedema and 19.6% of eyes (9/46) with pseudopapilledema. Post-hoc analyses eliminated six questionable cases of pseudopapilledema that had ancillary testing suggestive of elevated intracranial pressure and resulted in one remaining eye (2%) with more certain pseudopapilledema that was found to have folds. En face OCT imaging was more sensitive (71%) in detection of folds than axial OCT imaging (57%).

conclusionsChoroidal and/or retinal folds on OCT are commonly observed in patients with mild papilloedema and are uncommon in those with pseudopapilledema. The presence of folds on OCT in patients presenting with disc elevation suggests papilloedema.

Indexed as

PapilledemaCross-Sectional StudiesEye Diseases, HereditaryHumansNerve FibersOptic Nerve DiseasesRetinal Ganglion CellsTomography, Optical Coherence

Identifiers

PMID33469131
PMCPMC8526821
OpenAlexW3123922975

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.