Optic Neuropathy in Idiopathic Intracranial Hypertension

Abstract

Adult patients who present with papilloedema and symptoms of raised intracranial pressure need urgent multidisciplinary assessment including neuroimaging, to exclude life-threatening causes. Where there is no apparent underlying cause for the raised intracranial pressure, patients are considered to have idiopathic intracranial hypertension (IIH). Objectives: This review encompasses the newly revised diagnostic criteria for PTCS in adults and children and the role of obesity in the epidemiology, etiology, and management of IIH.Furthermore, this paper tries to offer a practical approach to assessing patients with papilloedema, the investigations and the subsequent management of patients with IIH. Methodology: PubMed was used to search for IIH and Pseudotumor Cerebri. The vast majority of the literature consisted of cohort studies, case control studies, systematic reviews and other narrative reviews. Conclusion: Idiopathic intracranial hypertension (IIH), also known as primary Pseudotumor Cerebri syndrome (PTCS), is a condition of unknown etiology which affects primarily overweight, reproductive-aged women and causes increased intracranial pressure (ICP). This review discusses the recently revised diagnostic criteria for IIH for adults and children and the controversial issues in its diagnosis and management.

Optical coherence tomography assessment of structural changes in the optic nerve head and peripapillary retina in idiopathic intracranial hypertension

“…Central field visual acuity can be normal until late in the course of the disease. Visual field changes are a more sensitive parameter in detecting visual loss associated with IIH, however, it depends largely on the patients collaboration and cannot be used in young children 19,20 . Therefore, identifying structural changes in the OHH is important in assessing the response to treatment or worsening of the disease.…”