{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:46:00Z","timestamp":1770749160756,"version":"3.50.0"},"reference-count":34,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: To examine longitudinal changes in total retinal nerve fiber layer thickness (RNFLT) as the primary outcome measure in newly diagnosed pediatric idiopathic intracranial hypertension (IIH) patients using Spectral-Domain Optical Coherence Tomography (SD-OCT) at one-year follow-up. Methods: This is a prospective observational cohort study with cross-sectional control-group comparison. We included children with clinically definite IIH (IIH group) and children without papilledema and a normal neurological exam as a control group. Optic nerve parameters, including the primary outcome measure RNFLT and secondary outcome measures such as total retinal thickness (TRT) and optic disk area (ODA), were evaluated using SD-OCT (3D OCT-2000, Topcon, Topcon Corporation, Tokyo, Japan). Evaluations took place at presentation and, for the IIH group, before lumbar puncture (LP), at 1-day post-LP and at 1-, 3-, 6-, and 12-month follow-ups. Results: A total of 44 children aged 7\u201317 years were recruited (IIH group: N = 19, control group: N = 25). The mean baseline RNFLT was 133.1 \u00b1 18.5 \u00b5m and 113.1 \u00b1 8.7 \u00b5m for the IIH and control groups (p &lt; 0.001), respectively. The IIH group showed a significant decline in RNFLT at the third-month follow-up. Between 3-month to one-year follow-up, mean total RNFLT showed an insignificant decline of 6 \u00b5m and did not differ from the RNFLT of the control group; however, segmental analysis of RNFLT showed a significant decline in the thickness of the nasal segments. At the one-year follow-up, two children had significant thinning of RNFLT at the superior quadrant. Intracranial pressure measured in the IIH group was directly correlated with RNFLT at the superior segment. Conclusions: SD-OCT is a useful non-invasive adjunct tool for the diagnosis and follow-up of IIH in children from primary school age onward. RNFL thickening resolved in most children at 3 months from IIH diagnosis. The study is constrained by specific methodological limitations, including a small sample size and non-contemporaneous evaluation of the control group compared with the IIH group. The significance of the segmental RNFL changes observed after one year should be further investigated with regard to long-term development, if possible with a larger prospective study that also considers the ganglion cell layer to explore for permanent axonal damage to the optic nerve.<\/jats:p>","DOI":"10.3390\/diagnostics16030457","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:12:46Z","timestamp":1770041566000},"page":"457","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Spectral-Domain-OCT-Guided One-Year Follow-Up of Newly Diagnosed Pediatric Idiopathic Intracranial Hypertension Patients"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2453-2231","authenticated-orcid":false,"given":"Yuval","family":"Cohen","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Ziv Medical Center, Safed 1311001, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel"},{"name":"Department of Ophthalmology, Hillel Yaffe Medical Center, Hadera 3820302, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Eidel","sequence":"additional","affiliation":[{"name":"Pediatric Neurology and Child Development Institute, Hillel Yaffe Medical Center, Hadera 3820302, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aviv","family":"Vidan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ziv Medical Center, Safed 1311001, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilad","family":"Hadar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ziv Medical Center, Safed 1311001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2624-6706","authenticated-orcid":false,"given":"Otzem","family":"Chassid","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ziv Medical Center, Safed 1311001, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1055\/s-0039-1698743","article-title":"Pediatric Idiopathic Intracranial Hypertension","volume":"39","author":"Gaier","year":"2019","journal-title":"Semin. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.ncl.2024.02.001","article-title":"The Pseudotumor Cerebri Syndrome","volume":"42","author":"Friedman","year":"2024","journal-title":"Neurol. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/head.13236","article-title":"Idiopathic Intracranial Hypertension in Children and Adolescents: An Update","volume":"58","year":"2018","journal-title":"Headache"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1212\/WNL.0b013e3182a55f17","article-title":"Revised Diagnostic Criteria for the Pseudotumor Cerebri Syndrome in Adults and Children","volume":"81","author":"Friedman","year":"2013","journal-title":"Neurology"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Malem, A., Sheth, T., and Muthusamy, B. (2021). Paediatric Idiopathic Intracranial Hypertension (IIH)-A Review. Life, 11.","DOI":"10.3390\/life11070632"},{"key":"ref_6","first-page":"e24915","article-title":"Optic Disc Edema and Elevated Intracranial Pressure (ICP): A Comprehensive Review of Papilledema","volume":"14","author":"Reier","year":"2022","journal-title":"Cureus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1007\/s00417-010-1527-2","article-title":"OCT for Optic Disc Evaluation in Idiopathic Intracranial Hypertension","volume":"249","author":"Skau","year":"2011","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jaapos.2017.09.003","article-title":"Bruch\u2019s Membrane Opening on Optical Coherence Tomography in Pediatric Papilledema and Pseudopapilledema","volume":"22","author":"Thompson","year":"2018","journal-title":"J. AAPOS"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.pediatrneurol.2015.10.022","article-title":"Use of Ocular Coherence Tomography in Children With Idiopathic Intracranial Hypertension-A Single-Center Experience","volume":"58","author":"Lee","year":"2016","journal-title":"Pediatr. Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.jaapos.2007.06.018","article-title":"Optical Coherence Tomography as a Tool for Monitoring Pediatric Pseudotumor Cerebri","volume":"11","author":"Holgado","year":"2007","journal-title":"J. AAPOS"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1136\/bjophthalmol-2015-307043","article-title":"Anatomic and Visual Function Outcomes in Paediatric Idiopathic Intracranial Hypertension","volume":"100","author":"Gospe","year":"2016","journal-title":"Br. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e046935","DOI":"10.1136\/bmjopen-2020-046935","article-title":"Detection of Intracranial Hypertension in Children Using Optical Coherence Tomography: A Systematic Review","volume":"11","author":"Rufai","year":"2021","journal-title":"BMJ Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.jaapos.2016.08.012","article-title":"Use of MultiColor Imaging in the Assessment of Suspected Papilledema in 20 Consecutive Children","volume":"20","author":"Malem","year":"2016","journal-title":"J. AAPOS"},{"key":"ref_14","first-page":"383","article-title":"Utility of optic coherence tomography (OCT) in the follow-up of idiopathic intracranial hypertension in childhood","volume":"81","author":"Bringas","year":"2006","journal-title":"Arch. Soc. Esp. Oftalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2678","DOI":"10.1167\/iovs.09-4403","article-title":"Optimizing Hand-Held Spectral Domain Optical Coherence Tomography Imaging for Neonates, Infants, and Children","volume":"51","author":"Maldonado","year":"2010","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e048745","DOI":"10.1136\/bmjopen-2021-048745","article-title":"Recognition of Intracranial Hypertension Using Handheld Optical Coherence Tomography in Children (RIO Study): A Diagnostic Accuracy Study Protocol","volume":"12","author":"Rufai","year":"2022","journal-title":"BMJ Open"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"104367","DOI":"10.1016\/j.pdpdt.2024.104367","article-title":"Clinical Correlation of Optic Nerve Head Analysis Performed by SD-OCT in Children with Pseudopapilledema and Papilledema","volume":"50","author":"Iritas","year":"2024","journal-title":"Photodiagnosis Photodyn. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1177\/0394632016681578","article-title":"Therapeutic Approaches to Pediatric Pseudotumor Cerebri: New Insights from Literature Data","volume":"30","author":"Vitaliti","year":"2017","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s00415-010-5750-x","article-title":"Disease Activity in Idiopathic Intracranial Hypertension: A 3-Month Follow-up Study","volume":"258","author":"Skau","year":"2011","journal-title":"J. Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1016\/j.ophtha.2015.06.003","article-title":"Papilledema Outcomes from the Optical Coherence Tomography Substudy of the Idiopathic Intracranial Hypertension Treatment Trial","volume":"122","author":"Auinger","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Hales, C.M., Freedman, D.S., Akinbami, L., Wei, R., and Ogden, C.L. (2022). Evaluation of Alternative Body Mass Index (BMI) Metrics to Monitor Weight Status in Children and Adolescents With Extremely High BMI Using CDC BMI-for-Age Growth Charts. NCHS National Vital Statistics Reports, CDC Stacks.","DOI":"10.15620\/cdc:121711"},{"key":"ref_22","first-page":"4395","article-title":"Performance of Topcon 3D Optical Coherence Tomography-2000 in Re-Analyzing OCT-1000 Raw Data","volume":"17","author":"Chen","year":"2019","journal-title":"Exp. Ther. Med."},{"key":"ref_23","first-page":"808-e57","article-title":"Optical Coherence Tomography Represents a Sensitive and Reliable Tool for Routine Monitoring of Idiopathic Intracranial Hypertension with and without Papilledema","volume":"26","author":"Eleftheriou","year":"2019","journal-title":"Eur. J. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.jcjo.2021.06.009","article-title":"Visual Outcomes in Idiopathic Intracranial Hypertension in Children","volume":"57","author":"Chiu","year":"2022","journal-title":"Can. J. Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s11916-019-0795-8","article-title":"Pseudotumor Cerebri Syndrome in Children","volume":"23","author":"Barmherzig","year":"2019","journal-title":"Curr. Pain. Headache Rep."},{"key":"ref_26","first-page":"105","article-title":"Pseudotumor Cerebri in the Paediatric Population: Clinical Features, Treatment and Prognosis","volume":"39","year":"2024","journal-title":"Neurologia (Engl. Ed.)"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"19218","DOI":"10.1038\/s41598-022-23960-w","article-title":"Improving Pediatric Idiopathic Intracranial Hypertension Care: A Retrospective Cohort Study","volume":"12","author":"Bulkowstein","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"103806","DOI":"10.1016\/j.jaapos.2023.11.009","article-title":"Concomitant Optic Disk Drusen and Papilledema Due to Idiopathic Intracranial Hypertension in a Pediatric Cohort","volume":"28","author":"Tavakoli","year":"2024","journal-title":"J. AAPOS"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Genizi, J., Meiselles, D., Arnowitz, E., Segal, I., Cohen, R., and Goldenberg-Cohen, N. (2021). Optic Nerve Drusen Is Highly Prevalent Among Children With Pseudotumor Cerebri Syndrome. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.789673"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1016\/j.ophtha.2020.03.027","article-title":"Imaging Methods for Differentiating Pediatric Papilledema from Pseudopapilledema: A Report by the American Academy of Ophthalmology","volume":"127","author":"Chang","year":"2020","journal-title":"Ophthalmology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1038\/s41433-025-03764-8","article-title":"Diagnostic Accuracy of Optic Nerve OCT and Ultrasound in a Large Paediatric Cohort Referred with Suspected Papilloedema and Very Low Rates of Raised ICP","volume":"39","author":"Ambrose","year":"2025","journal-title":"Eye"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1007\/s00415-017-8532-x","article-title":"Optical Coherence Tomography for the Diagnosis and Monitoring of Idiopathic Intracranial Hypertension","volume":"264","author":"Albrecht","year":"2017","journal-title":"J. Neurol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"14859","DOI":"10.1038\/s41598-025-96831-9","article-title":"Optical Coherence Tomography Surpasses Fundus Imaging and Intracranial Pressure Measurement in Monitoring Idiopathic Intracranial Hypertension","volume":"15","author":"Eriksson","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1055\/s-0034-1376202","article-title":"Reference Range of Cerebrospinal Fluid Opening Pressure in Children: Historical Overview and Current Data","volume":"45","author":"Avery","year":"2014","journal-title":"Neuropediatrics"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/3\/457\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T14:30:47Z","timestamp":1770042647000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/3\/457"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":34,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["diagnostics16030457"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16030457","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,1]]}}}