Do Optic Canal Dimensions Measured on CT Influence the Degree of Papilloedema and Visual Dysfunction in Idiopathic Intracranial Hypertension?

Skipper, Nicholas T.; Igra, Mark; Littlewood, Revelle; Armitage, Paul A.; Laud, Peter J.; Mollan, Susan P; Sharrack, Basil; Pepper, Irene M; Batty, Ruth; Connolly, Daniel; Hickman, Simon J.

doi:10.1080/01658107.2018.1483406

Cited by 9 publications

(10 citation statements)

References 20 publications

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“…The majority of included studies on LCSF op (81%) performed pressure measurement in a lateral recumbent position [ 7 , 9 , 22 , 27 , 28 , 30 – 35 , 41 , 43 , 63 – 73 ], and a reference interval in this position from 7.2 to 16.8 mmHg was established. There was no significant difference between the reference intervals in healthy individuals versus pseudo-healthy individuals.…”

Section: Discussionmentioning

confidence: 99%

Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review

Norager

Olsen

Pedersen

et al. 2021

Fluids Barriers CNS

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Background Although widely used in the evaluation of the diseased, normal intracranial pressure and lumbar cerebrospinal fluid pressure remain sparsely documented. Intracranial pressure is different from lumbar cerebrospinal fluid pressure. In addition, intracranial pressure differs considerably according to the body position of the patient. Despite this, the current reference values do not distinguish between intracranial and lumbar cerebrospinal fluid pressures, and body position-dependent reference values do not exist. In this study, we aim to establish these reference values. Method A systematic search was conducted in MEDLINE, EMBASE, CENTRAL, and Web of Sciences. Methodological quality was assessed using an amended version of the Joanna Briggs Quality Appraisal Checklist. Intracranial pressure and lumbar cerebrospinal fluid pressure were independently evaluated and subdivided into body positions. Quantitative data were presented with mean ± SD, and 90% reference intervals. Results Thirty-six studies were included. Nine studies reported values for intracranial pressure, while 27 reported values for the lumbar cerebrospinal fluid pressure. Reference values for intracranial pressure were − 5.9 to 8.3 mmHg in the upright position and 0.9 to 16.3 mmHg in the supine position. Reference values for lumbar cerebrospinal fluid pressure were 7.2 to 16.8 mmHg and 5.7 to 15.5 mmHg in the lateral recumbent position and supine position, respectively. Conclusions This systematic review is the first to provide position-dependent reference values for intracranial pressure and lumbar cerebrospinal fluid pressure. Clinically applicable reference values for normal lumbar cerebrospinal fluid pressure were established, and are in accordance with previously used reference values. For intracranial pressure, this study strongly emphasizes the scarcity of normal pressure measures, and highlights the need for further research on the matter.

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Section: Discussionmentioning

confidence: 99%

Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review

Norager

Olsen

Pedersen

et al. 2021

Fluids Barriers CNS

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“…Other studies have examined the anatomical changes in the optic canal to predict visual outcome, but these have shown conflicting results. An MRI study [ 97 ] reported poor visual function and severe papilloedema or optic atrophy in association with a larger optic canal, while a CT imaging study [ 98 ] found no correlation between any of the optic canal measurements and papilloedema grade and no significant difference in optic canal measurements between IIH patients and controls.…”

Section: Patient Monitoring and Prognosismentioning

confidence: 99%

Reviewing the Recent Developments in Idiopathic Intracranial Hypertension

et al. 2020

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There is increasing evidence and appreciation of idiopathic intracranial hypertension (IIH) in medicine. The pathological processes underlying raised intracranial pressure are being studied, with new insights found in both hormonal dysregulation and the metabolic neuroendocrine axis. These will potentially lead to novel therapeutic targets for IIH. The first consensus guidelines have been published on the investigation and management of adult IIH, and the International Headache Society criteria for headache attributable to IIH have been modified to reflect our evolving understanding of IIH. Randomized clinical trials have been published, and a number of studies in this disease area are ongoing.

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“…[ 26 ] However, studies using CT to delineate bony optic canal anatomy did not find a correlation between optic canal measurements and papilledema grade. [ 27 28 ] In addition, there was no difference in the optic canal measurements between the eyes of patients with asymmetric papilledema, and no significant difference in the canal measurements between IIH patients and controls.…”

Section: Atypical Presentationsmentioning

confidence: 91%

“…Several hypotheses have been proposed for unilateral or asymmetric papilledema, including compartmentation of the perioptic subarachnoid space, optic canal asymmetry, and asymmetry of intraocular pressure (IOP). [ 21 25 26 27 28 29 ]…”

Section: Atypical Presentationsmentioning

confidence: 99%

Atypical presentations of idiopathic intracranial hypertension

Chen

Newman

Biousse

2021

Taiwan J Ophthalmol

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Idiopathic intracranial hypertension (IIH) is a disorder of unknown etiology that results in isolated raised intracranial pressure. Classic symptoms and signs of IIH include headache, papilledema, diplopia from sixth nerve palsy and divergence insufficiency, and pulsatile tinnitus. Atypical presentations include: (1) highly asymmetric or even unilateral papilledema, and IIH without papilledema; (2) ocular motor disturbances from third nerve palsy, fourth nerve palsy, internuclear ophthalmoplegia, diffuse ophthalmoplegia, and skew deviation; (3) olfactory dysfunction; (4) trigeminal nerve dysfunction; (5) facial nerve dysfunction; (6) hearing loss and vestibular dysfunction; (7) lower cranial nerve dysfunction including deviated uvula, torticollis, and tongue weakness; (8) spontaneous skull base cerebrospinal fluid leak; and (9) seizures. Although atypical findings should raise a red flag and prompt further investigation for an alternative etiology, clinicians should be familiar with these unusual presentations.

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Do Optic Canal Dimensions Measured on CT Influence the Degree of Papilloedema and Visual Dysfunction in Idiopathic Intracranial Hypertension?

Cited by 9 publications

References 20 publications

Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review

Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review

Reviewing the Recent Developments in Idiopathic Intracranial Hypertension

Atypical presentations of idiopathic intracranial hypertension

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