Systematic Approch and Ancillary Testing for Diagnosis of Papilledema and Differential Diagnosis from Pseudopapilledema

Abstract

Papilledema resulting from elevated intracranial pressure is one of the important entities that need urgent evaluation in ophthalmology practice. Although diagnosis can readily be made in established clinical presentations with advanced papilledema by experienced clinicians, differential diagnosis should be made meticulously in pediatric patients and in case of subtle edema. In particular, early papilledema must be distinguished from pseudopapilledema by clinical fi ndings and ancillary testing. In this review, we attempted to present important approaches that could be used for diagnosis, differential diagnosis and follow-up of papilledema and pseudopapilledema, including ancillary testing (optical coherence tomography, sonography, magnetic resonance imaging and magnetic resonance venography) in diagnosis of papilledema, differential diagnosis of papilledema-pseudopapilledema and follow up of these two diseases.