PAPILLEDEMA: CORRELATION BETWEEN OPHTHALMOLOGICAL FINDINGS AND NEUROLOGICAL CAUSES — A SYSTEMATIC REVIEW

Abstract

Introduction: Papilledema represents a neuro-ophthalmological manifestation of elevated intracranial pressure and requires urgent differentiation from other causes of optic disc swelling.

Objective: To systematically analyze contemporary evidence correlating ophthalmological findings with the spectrum of neurological causes underlying papilledema, with emphasis on structural imaging, functional impairment, and neuroimaging markers.

Methods: A systematic review was conducted according to PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, ICTRP, and Google Scholar. Studies published within the last five years were prioritized and evaluated using RoB 2, ROBINS-I, and QUADAS-2 tools, with certainty of evidence assessed using the GRADE framework.

Results and Discussion: Twenty-five studies were included in the qualitative synthesis. Structural optical coherence tomography parameters, particularly peripapillary retinal nerve fiber layer thickness and ganglion cell-inner plexiform layer metrics, demonstrated consistent correlation with papilledema severity and treatment response. Magnetic resonance imaging markers such as posterior globe flattening and perioptic subarachnoid space distension enhanced etiological identification.

Conclusion: Papilledema requires a multidisciplinary diagnostic approach integrating quantitative ophthalmological imaging and standardized neuroimaging criteria. Early detection and objective monitoring are fundamental to preventing irreversible visual impairment. Harmonized imaging protocols and prospective multicenter validation studies are necessary to optimize clinical algorithms.