{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:32:24Z","timestamp":1786649544669,"version":"build-2736575974"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Differentiating between papilledema and pseudopapilledema can be challenging in certain cases. Relying solely on subjective clinical examination may lead to confusion, and objective diagnostic confirmation methods may pose challenges such as cost, operator dependency, invasiveness or limited availability. This study seeks to assess whether retinal nerve fiber layer (RNFL) analysis can serve as a reliable measurement for establishing the diagnosis. A thorough literature search was conducted on PubMed, ProQuest, Google Scholar and Cochrane from 2012 to 2023, with the last search conducted on March 26, 2023. Non-English studies, review articles, case studies and editorial letters were excluded. The inclusion criteria comprised studies with available full text containing both papilledema and pseudopapilledema groups, with outcomes on sensitivity, specificity and\/or area under the curve (AUC). This study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guideline. A total of 510 participants were included from seven different studies, all encompassing groups of papilledema and pseudopapilledema with or without optic disc drusen (ODD). The studies demonstrated the favorable accuracy of RNFL in differentiating papilledema from pseudopapilledema, with AUC values ranging from 0.78 to 0.91. However, specificity and sensitivity varied between 65%\u2013100% and 33%\u201391%, respectively. Lower accuracy was observed when pseudopapilledema included only patients with ODD or when papilledema was limited to mild cases. In conclusion, RNFL proves to be a reliable measurement for differentiating papilledema from pseudopapilledema.<\/jats:p>","DOI":"10.4103\/ijo.ijo_3364_23","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T11:03:15Z","timestamp":1748430195000},"page":"792-796","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["The reliability of retinal nerve fiber layer analysis to differentiate between papilledema and pseudopapilledema: A systematic review"],"prefix":"10.4103","volume":"73","author":[{"given":"Lourisa Ruth","family":"Eldinia","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine University of Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rona Ali","family":"Badjrai","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine University of Indonesia - 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Cipto Mangunkusumo Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syntia","family":"Nusanti","sequence":"additional","affiliation":[{"name":"Neuro-ophthalmology Division, Department of Ophthalmology, Faculty of Medicine University of Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"R3-20260422","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/OPX.0000000000001408","article-title":"Custom optical coherence tomography parameters for distinguishing papilledema from pseudopapilledema","volume":"96","author":"Pardon","year":"2019","journal-title":"Optom Vis Sci"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.4103\/0301-4738.149136","article-title":"Optical coherence tomography in papilledema and pseudopapilledema with and without optic nerve head drusen","volume":"62","author":"Bassi","year":"2014","journal-title":"Indian J Ophthalmol"},{"key":"R5-20260422","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1167\/iovs.18-25453","article-title":"Optical coherence tomography angiography in papilledema compared with pseudopapilledema","volume":"60","author":"Fard","year":"2019","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R6-20260422","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1097\/OPX.0000000000001148","article-title":"Use of A-scan ultrasound and optical coherence tomography to differentiate papilledema from pseudopapilledema","volume":"94","author":"Saenz","year":"2017","journal-title":"Optom Vis Sci"},{"key":"R7-20260422","doi-asserted-by":"crossref","first-page":"3715","DOI":"10.3390\/jcm11133715","article-title":"Optic nerve drusen evaluation: A comparison between ultrasound and OCT","volume":"11","author":"Rosa","year":"2022","journal-title":"J Clin Med"},{"key":"R8-20260422","doi-asserted-by":"crossref","first-page":"e509","DOI":"10.1097\/WNO.0000000000001087","article-title":"Utility of spectral-domain optical coherence tomography in differentiating papilledema from pseudopapilledema: A prospective longitudinal study","volume":"41","author":"Jivraj","year":"2021","journal-title":"J Neuroophthalmol"},{"key":"R9-20260422","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1097\/WNO.0000000000001248","article-title":"Utility of ultrasound and optical coherence tomography in differentiating between papilledema and pseudopapilledema in children","volume":"41","author":"Farazdaghi","year":"2021","journal-title":"J Neuroophthalmol"},{"key":"R10-20260422","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1097\/WNO.0000000000001078","article-title":"Optical coherence tomography neuro-toolbox for the diagnosis and management of papilledema, optic disc edema, and pseudopapilledema","volume":"41","author":"Sibony","year":"2021","journal-title":"J Neuroophthalmol"},{"key":"R11-20260422","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1136\/pgmj.2005.040857","article-title":"Ageing changes in the eye","volume":"82","author":"Salvi","year":"2006","journal-title":"Postgrad Med J"},{"key":"R12-20260422","doi-asserted-by":"crossref","first-page":"500","DOI":"10.3390\/diagnostics12020500","article-title":"Thicker retinal nerve fiber layer with age among schoolchildren: The Hong Kong children eye study","volume":"12","author":"Zhang","year":"2022","journal-title":"Diagnostics (Basel)"},{"key":"R13-20260422","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1016\/j.ophtha.2018.04.036","article-title":"Peripapillary ovoid hyperreflectivity in optic disc edema and pseudopapilledema","volume":"125","author":"Malmqvist","year":"2018","journal-title":"Ophthalmology"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_3364_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:55:14Z","timestamp":1786647314000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_3364_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,28]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_3364_23","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,28]]},"assertion":[{"value":"2023-12-28","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}