Weight reduction for a better visual outcome in idiopathic intracranial hypertension

Koç, Feray; Isik, Mehmet Resit; Sefi-Yurdakul, Nazife

doi:10.5935/0004-2749.20180006

Cited by 9 publications

(16 citation statements)

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“…The greatest weight loss with a lifestyle intervention was reported using a very low-energy diet (VLED) dietary intervention with a 15.7 kg at 3 months (Level 2+ 6 ). Short-term dietary interventions resulted in modest reductions in BMI of 2.0–2.3 kg/m 2 at 3–6 months (Level 2− to 2+ 26,29 ). At a median of 10–11 months of follow-up of a dietary intervention, weight loss was not significant; however, the addition of 2.25 g/d of metformin led to a mean weight loss of 6.9% and 8.2% in patients with hyperinsulinaemia and polycystic ovary syndrome, respectively (Level 2+ 25 ).…”

Section: Resultsmentioning

confidence: 99%

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Weight Management Interventions for Adults With Idiopathic Intracranial Hypertension

Abbott,

Chan,

Tahrani

et al. 2023

Neurology

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Background and ObjectivesIdiopathic intracranial hypertension (IIH) is associated with obesity, however there is a lack of clinical consensus on how to manage weight in IIH. The aim of this systematic review is to evaluate weight loss interventions in people with IIH to determine which intervention is superior in terms of weight loss, reduction in intracranial pressure, benefit to visual and headache outcomes, quality of life, and mental health.MethodsA systematic review was carried out in accordance with PRISMA guidelines and registered with PROSPERO (CRD42023339569). MEDLINE and CINAHL were searched for relevant literature published from inception until 15thDecember 2022. Screening and quality appraisal was conducted by two independent reviewers. Recommendations were graded using Scottish Intercollegiate Guidelines Network (SIGN) methodology.ResultsA total of 17 studies were included. Bariatric surgery resulted in 27.2-27.8kg weight loss at 24 months (Level 1- to 1++). Lifestyle weight management interventions resulted in between 1.4 to 15.7kg weight loss (Level 2+ to 1++). Bariatric surgery resulted in the greatest mean reduction in ICP (-11.9cm H2O) at 24 months (Level 1++), followed by multi-component lifestyle intervention + acetazolamide (-11.2cm H2O) at 6 months (Level 1+), and then a very low energy diet intervention (-8.0cm H2O) at 3 months (Level 2++). The least ICP reduction was shown at 24 months after completing a 12-month multi-component lifestyle intervention (-3.5 cm H2O) (Level 1++). Reduction in body weight was shown to be highly correlated with reduction in ICP (Level 2++ to 1++).DiscussionBariatric surgery should be considered for women with IIH and a BMI ≥35kg/m2since this had the most robust evidence for sustained weight management (Grade A). A multi-component lifestyle intervention (diet + physical activity + behaviour) had the most robust evidence for modest weight loss with a BMI <35kg/m2(Grade B). Longer term outcomes for weight management interventions in people with IIH are required, to determine if there is a superior weight loss intervention for IIH.

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Section: Resultsmentioning

confidence: 99%

“…There were 6 studies 7,20,21,31-33 of randomized control trials (RCTs), 4 prospective nonrandomized interventional studies, 6,24,25,30 and 2 prospective 27,29 and 4 retrospective observational studies. 5,22,23,26,28 Prescribed concomitant IIH pharmacotherapy is presented in eTable 1 (links.lww.com/WNL/D149).…”

Section: Resultsmentioning

confidence: 99%

Weight Management Interventions for Adults With Idiopathic Intracranial Hypertension

Abbott,

Chan,

Tahrani

et al. 2023

Neurology

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“…Moreover, Celebisoy N. and co-authors [16] showed visual field improvement on either acetazolamide or topiramate considering that the two medications exert their effect through the carbonic anhydrase inhibition. Nevertheless, Koc F and his colleagues 2018 [17] showed in their recent study that the weight reduction combined with acetazolamide significantly improve the visual field in IIH patients. The discrepancy in the results could be attributed to different methodology applied in the studies.…”

Section: Discussionmentioning

confidence: 99%

Quantitative d-dimer level and anticoagulant therapy in idiopathic intracranial hypertension

Shaheen

Sobhy

Mously

et al. 2019

Egypt J Neurol Psychiatry Neurosurg

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Background: Idiopathic intracranial hypertension (IIH) is a syndrome characterized by elevated intracranial pressure (ICP) of unknown etiology Aim of the work: The aim of this research is to study the quantitative D-dimer level and the role of anticoagulant therapy in absence of occlusive sinus thrombosis in patients with IIH. Methodology: Twenty-four patients with IIH according to the modified Dandy criteria were enrolled. Headache impact test (HIT6), ophthalmological assessment including Frisen classification for papilledema, visual acuity, visual field, and visual evoked potentials were performed to the patients. Serum quantitative D-dimer level was measured using the enzyme-linked immunosorbent assay (ELISA) technique for the patients and for 24 healthy matched controls. Patients were divided into two groups: group (1) received acetazolamide and low molecular weight heparin (LMWH) in a prophylactic dose for 2 weeks while group (2) received acetazolamide only. Both groups continued on acetazolamide for 6 months. We followed the patients after 1 and 6 months later through the HIT6 test and the ophthalmological assessment. Results: D-dimer level was statistically higher among the cases compared to the controls. Also, a statistically significant improvement was recorded in the ophthalmological assessment after 6 months among both groups; more evident in group (1). Conclusion: The elevated D-dimer level and the visual improvement in IIH patients receiving LMWH added to acetazolamide suggest the presence of an underlying unrecognized non-occlusive venous cerebral microthrombi impeding the cerebrospinal fluid (CSF) drainage.

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“…A paciente do relato, de 53 anos, estava na menopausa e fazia uso de reposição hormonal. Dessa forma, torna-se necessário e deve ser encorajado nesses pacientes um programa de perda de peso através de dieta, exercício e intervenção comportamental, associado a tratamento medicamentoso que reduza a produção de LCR 10,11 .…”

Section: Discussionunclassified

Importance of diagnosis and treatment of chronic idiopathic intracranial hypertension and its ocular repercussions: a case report

Soares¹,

Cruz²,

Santos³

et al. 2022

eOftalmo

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Weight reduction for a better visual outcome in idiopathic intracranial hypertension

Cited by 9 publications

References 0 publications

Weight Management Interventions for Adults With Idiopathic Intracranial Hypertension

Weight Management Interventions for Adults With Idiopathic Intracranial Hypertension

Quantitative d-dimer level and anticoagulant therapy in idiopathic intracranial hypertension

Importance of diagnosis and treatment of chronic idiopathic intracranial hypertension and its ocular repercussions: a case report

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