Happy Easter
Gliotic discs after papilledema are not uncommon after papilledema and may represent a diagnostic dilemma in recurrent cases , after resolution of the disease they may turn a true papilledema into pseudopapilledema with the disc frozen to a certain shape and degree of elevation that may be there forever and with the recurrent nature of the disease and with a second and third attack will not reflect the changes in the ICP or the subarachnoid pressure of the optic nerve
OCT although may give some wonderful imaging portraits may not even solve the problem for different factors cause a disc that suffered papilledema may have affected RNFL thickness after the disease but with recurrence the RNFL who's actually thickened from their affected state will come to a false normal value and this is misleading except if you have a reference or sequential examination on the RNFL
For the gliosis itself it is looked at as a clinical diagnosis but there are no studies to my knowledge that tried to measure the veil in front of the disc and changes that happens over time but all directed to studying the progression and regression of papilledema or the differentiation between papilledema and ODD or between ODD and PHOMS as were presented in the last conference in Tuscon.
So it is a very good idea for a new research using OCT specifically to measure the gliosis as an epiretinal or epi-papillary membrane and if changes over time in the same patient and it would be fascinating to study that in primary and recurrent cases in the same patient
I have a question or suggestion for you Deb if you can retrospectively reanalyse date for those patients if you have older scan for some of your patients
One last thing about the reference is the papilledema chapter written by Neil miller and Nancy Newman in Walsh and Hoyet in the 4th edition I think may contain some references about this area but I think will not be recent