Characteristics of Ocular Fundus in Brain Infections at Cipto Mangunkusumo Hospital Jakarta

Abstract

Background: Brain infections (BI) may cause optic nerve abnormalities. Awareness on optic nerve abnormalities will be useful in assisting further management. The characteristics of the ocular fundus (fundus) in BI have not been widely studied in Indonesia. This study aims to apprehend the depiction of the fundus in BI in Cipto Mangunkusumo Hospital Jakarta (RSCM).

Methods: Cross-sectional study conducted on October-December 2021 at RSCM.  Images from 20D-lens fundoscopy were captured with a digital camera. Results are analyzed if there are similarities between at least two examiners.

Results: There were 49 subjects whose fundoscopy results could be analyzed. A total of 25 subjects has normal fundus. Abnormalities were seen in 8 subjects, which comprised of 4 (12.1%) papilledema, 3 (9.1%) papillatrophy and 1 (3%) retinal haemorrhage. The highest mean aperture pressure was found in the papillatrophy group (37cmH₂O), followed by papilledema (27cmH₂O).

Discussion: BI can increase intracranial pressure (ICP). Nonetheless, we found only 12.1% had papilledema. The highest mean aperture pressure was found in the papillatrophy group which showed an increase in ICP over a long period of time. The highest mortality was found in the normal fundus group so that papilledema cannot be directly associated with a worse prognosis considering the uncontrolled confounding factors such as other BI complications.

Conclusion: Although BI causes an increase in ICP, papilledema is not always found. High aperture pressure was found in the papillatrophy group, but the highest mortality was found in the normal fundus group.