Anemia and papilledema

Biousse, Valérie; Rucker, Janet C.; Vignal, Catherine; Crassard, Isabelle; Katz, Bradley J.; Newman, Nancy J.

doi:10.1016/s0002-9394(02)02062-7

Cited by 113 publications

(92 citation statements)

References 25 publications

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“…8 Other studies have suggested that male gender, hypertension, recent weight gain, anemia, sleep apnea, puberty, and older age may be associated with poorer outcomes, but no consistent risk factors have emerged. 9,11,[17][18][19][20][21][22][23] The analyses in this study regarding factors associated with severe visual loss support black race, male gender, hypertension, higher degrees of obesity, anemia, and sleep apnea as associated with poorer outcomes. Interestingly, diplopia and pulsatile tinnitus were less frequently reported among patients with severe visual loss from IIH at their initial neuro-ophthalmology evaluation.…”

Section: Discussionmentioning

confidence: 66%

Racial differences in idiopathic intracranial hypertension

Bruce

Preechawat²,

Newman³

et al. 2008

Neurology

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Objective-To evaluate racial differences in idiopathic intracranial hypertension (IIH).Methods-Medical records of all consecutive patients with definite IIH seen between 1989 and 2006 were reviewed. Demographics, associated factors, and visual function at presentation and follow-up were collected. Black patients were compared to non-black patients. (197 black, 253 non-black). Obesity, systemic hypertension, anemia, and sleep apnea were more common in blacks than in non-blacks (p≤0.01). Cerebrospinal fluid opening pressure was higher in blacks (40 vs. 34 cm CSF, p<0.001). Visual acuity, visual field loss, and degree of papilledema at presentation and follow-up were worse in blacks (p≤0.01). Diagnostic and therapeutic measures were similar between blacks and non-blacks, except for optic nerve sheath fenestration (p=0.01) and lumbar puncture (p=0.03), both more commonly performed on black patients. The relative risk of severe visual loss for blacks compared with non-blacks was 3.5 (95%CI 2.0-5.8, p<0.001) in at least one eye and 4.8 (95%CI 2.1-10.9, p<0.001) in both eyes. Logistic regression analysis supported race, anemia, body mass index, and male gender as independent risk factors for severe visual loss and suggested that racial differences may be partially accounted for by differences in CSF opening pressure, body mass index, and frequency of anemia. Results-We included 450 patientsConclusion-Black IIH patients were more likely than non-black IIH patients to have severe visual loss in at least one eye. This difference did not appear to result from diagnosis, treatment, or access to care, but may partially relate to differences in other risk factors. Black patients have a more aggressive disease and may need closer follow-up and lower thresholds for early intervention.

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Section: Discussionmentioning

confidence: 66%

Racial differences in idiopathic intracranial hypertension

Bruce

Preechawat²,

Newman³

et al. 2008

Neurology

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“…We present the only study, to our knowledge, which examines the relationship between clinical course and TSS among patients with IIH. Our quantitative measures of the TSs were not predictive of the clinical course of patients with IIH, suggesting that other factors such as those previously associated with poor outcomes in IIH 14,31,32 (i.e., black race, male sex, anemia, recent weight gain, and morbid obesity) are more relevant than the anatomic degree of TSS. Most importantly, our study does not support the notion that patients with IIH with high-grade stenosis on MRV require TS stenting or need different management than patients with IIH without severe TSS in order to prevent poor outcomes.…”

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confidence: 60%

Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis

et al. 2013

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Objective: Transverse sinus stenosis (TSS) is common in idiopathic intracranial hypertension (IIH), but its effect on the course and outcome of IIH is unknown. We evaluated differences in TSS characteristics between patients with IIH with "good" vs "poor" clinical courses.Methods: All patients with IIH seen in our institution after September 2009 who underwent a high-quality standardized brain magnetic resonance venogram (MRV) were included. Patients were categorized as having a good or poor clinical course based on medical record review. The location and percent of each TSS were determined for each patient, and were correlated to the clinical outcome. Results:We included 51 patients. Forty-six patients had bilateral TSS. The median average percent stenosis was 56%. Seventy-one percent of patients had stenoses .50%. Thirty-five of the 51 patients (69%) had no final visual field loss. Eight patients (16%) had a clinical course classified as poor. There was no difference in the average percent stenosis between those with good clinical courses vs those with poor courses (62% vs 56%, p 5 0.44). There was no difference in the percent stenosis based on the visual field grade (p 5 0.38). CSF opening pressure was not associated with either location or degree of TSS. Conclusion: TSS is common, if not universal, among patients with IIH, and is almost always bilateral.There is no correlation between the degree of TSS and the clinical course, including visual field loss, among patients with IIH, suggesting that clinical features, not the degree of TSS, should be used to determine management in IIH. Idiopathic intracranial hypertension (IIH) is a syndrome of isolated elevated intracranial pressure (ICP) of unknown etiology, responsible for visual loss from papilledema in about 25% of cases.

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“…Observations can be summarized as under:  Most commonly affected age group was between [21][22][23][24][25][26][27][28][29][30] years in which 32% cases.  Least commonly affected age group were between age group of 51-60yr.…”

Section: Discussionmentioning

confidence: 99%

Optic Disc Edema/Papilledema: A Clinical Profile

Solanki¹,

Meena²,

Sharma³

et al. 2016

jemds

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AIMTo evaluate the clinical profile of patients with disc edema/papilloedema and its pattern in various patients. PURPOSETo evaluate causes of Disc edema/Papilloedema and associated clinical picture. DESIGNProspective Study. METHODThis study is a non-randomized prospective case series being conducted in the patients with disc edema attending OPD and referred from other departments to RIO, Gandhi Medical College and associated Hamidia Hospital, Bhopal from Jan 2013-Sept 2014. Detailed history was taken with special preference to diminution of vision, headache, nausea, vomiting, sensory motor deficits experienced by patient. Examination including visual acuity, pupillary reaction and ophthalmoscopy findings were noted. Findings of neuroimaging investigations as advised by medicine and surgery experts in cases suspected of raised intracranial tension were noted. RESULTSMost commonly affected age group was 11-20 years. Females: Males ratio were 4.1:3 with bilateral predominance. Intracranial Space Occupying Lesion (ICSOL) was most common cause of papilledema in bilateral (b/l) cases. Optic neuropathy was most common local cause of unilateral disc edema. Headache was the most common presenting complaint. On radiological investigations, most common finding was ICSOL followed by sinusitis followed by venous thrombosis, demyelination and infarction, Lateral Rectus (LR) palsy and diplopia each were found to be present in 4% cases of disc edema. CONCLUSIONIntracranial space occupying lesions as suggested by neuroimaging were the most common cause of papilledema. Other associations included hypertension, meningitis, pseudotumor cerebri, anaemia.The study emphasizes ophthalmoscopy in the diagnosis of papilledema and its importance in intervention of neurosurgeon in saving life and sight of person.

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Anemia and papilledema

Cited by 113 publications

References 25 publications

Racial differences in idiopathic intracranial hypertension

Racial differences in idiopathic intracranial hypertension

Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis

Optic Disc Edema/Papilledema: A Clinical Profile

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