Author Affiliations: Department of Ophthalmology and Visual Sciences, University of Iowa Carver School of Medicine and Veterans Affairs Hospital, Iowa City (Drs Kardon, Scott, Lee, and Wall); and Department of Clinical Neurosciences, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Dr Frisén).
We thank Savini and colleagues for their interesting comments regarding our article.1 They inquire about what effect papilledema had on features of OCT in the outer layers of the retina in our data set of patients with various grades of papilledema. Their inquiry has origin in their own observations of a “hyporeflective subretinal space” in time-domain B scans obtained using OCT (Stratus OCT; Zeiss Meditech, Dublin, California) of patients with papilledema2 and also analyzed in an article by Johnson et al3 identifying OCT characteristics that may differentiate papilledema from pseudopapilledema. While the authors are not certain about the cause of the observed hyporeflective subretinal space, they are of the opinion that it may represent an important structural feature of papilledema and wondered why we did not report on this feature in our study.
Kardon RH, Scott CJ, Lee AG, Frisén L, Wall M. Optical Coherence Tomography for Optic Disc Edema—Reply. Arch Ophthalmol. 2011;129(9):1245-1247. doi:10.1001/archophthalmol.2011.283