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Tytuł:
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Clinical and demographic differences between idiopathic intracranial hypertension patients with mild and severe papilledema.
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Autorzy:
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Micieli JA; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
Gorham JP; Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
Bruce BB; Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.; Department of Epidemiology, Emory University School of Medicine, Atlanta, GA, USA.
Newman NJ; Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.; Department of Neurological Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Biousse V; Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Peragallo JH; Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
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Źródło:
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Taiwan journal of ophthalmology [Taiwan J Ophthalmol] 2020 Oct 07; Vol. 11 (1), pp. 53-56. Date of Electronic Publication: 2020 Oct 07 (Print Publication: 2021).
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2017- : Mumbai : Medknow Publications
Original Publication: Taipei : Elsevier
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References:
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Contributed Indexing:
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Keywords: Demographics; idiopathic intracranial hypertension; papilledema; visual outcome
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Entry Date(s):
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Date Created: 20210326 Latest Revision: 20210327
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Update Code:
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20240105
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PubMed Central ID:
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PMC7971438
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DOI:
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10.4103/tjo.tjo_44_20
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PMID:
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33767955
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Purpose: The purpose of this study was to evaluate whether papilledema severity is associated with specific demographic or clinical factors in patients with idiopathic intracranial hypertension (IIH).
Materials and Methods: A retrospective cohort study of consecutive IIH patients seen at one tertiary care institution between 1989 and March 31, 2017 was performed. IIH patients were classified as mild (Frisén Grade 1 or 2) or severe (Frisén Grade 4 or 5) based on grading of fundus photographs obtained at first presentation. Demographic and clinical variables including age, body mass index (BMI), gender, visual acuity, Humphrey visual field mean deviation, and cerebrospinal fluid (CSF) opening pressure were extracted from patient medical records for statistical analyses.
Results: A total of 239 patients were included in the study: 152 with mild papilledema and 87 with severe papilledema. There was no difference in age, race, BMI, or male gender between the mild and severe papilledema groups. CSF opening pressure was significantly higher in the severe papilledema group (41.89 cm of water vs. 33.69, 95% confidence interval [CI]: -10.79--5.62, P < 0.0001). There was a significant difference in the Humphrey mean deviation (-6.38 dB compared to - 3.25 dB, 95% CI: -4.82--1.44 dB, P < 0.001) and average logarithm of the minimum angle of resolution visual acuity at final follow-up (0.21 vs. 0.045, 95% CI: -0.299--0.040 , P = 0.01).
Conclusion: Age, race, sex, and BMI were similar in IIH patients with mild versus severe papilledema, emphasizing the importance of a dilated fundus examination to reliably stratify patients. Patients with severe papilledema are at higher risk of visual acuity and visual field loss at final follow-up.
Competing Interests: The authors declare that there are no conflicts of interests of this paper.
(Copyright: © 2020 Taiwan J Ophthalmol.)
