Predictors of poor visual outcome in patients with Idiopathic Intracranial Hypertension (IIH): An ambispective cohort study

Clin Neurol Neurosurg. 2017 Aug:159:13-18. doi: 10.1016/j.clineuro.2017.05.009. Epub 2017 May 10.

Abstract

Objective: Idiopathic intracranial hypertension (IIH) is a disease of young with threat to vision if not diagnosed timely. This study looked at the putative predictors of poor visual outcome in patients with IIH at six months after presentation via a cohort study.

Patients and methods: All patients diagnosed with IIH from January 2011 to May 2015 were enrolled. The study design was ambispective cohort study. The baseline clinical and radiological characteristics assessed were age, sex, body mass index (BMI), duration of symptoms, transient visual obscuration, cranial nerve palsy, diminution of vision, Cerebrospinal fluid (CSF) opening pressure, empty sella, optic nerve dilatation, global configuration and transverse sinus stenosis. Follow up of visual outcome at six months was done to know the predictors of poor visual outcome.

Results: Eighty nine (89) patients were enrolled and 56 patients had follow-up of six months at the time of analysis. Majority of the patients were females (73/89 (82%)). The mean age was 29.9±11.0years. Mean body mass index (BMI) was 27.1±5.4kg/m2. Diminution of vision at presentation was seen in 54 (62%) patients. 64 eyes (36%) had visual acuity less than 6/18. Poor visual outcome at six months was seen in 23(41%) patients. Diminution of vision at presentation was found to be a poor predictor.

Conclusion: We found female sex and obesity to be less prevalent in our setting. Diminution of vision at presentation was a predictor of poor visual outcome at six months.

Keywords: Headache; Idiopathic Intracranial Hypertension; Pseudotumor cerebri; Visual fields; Visual loss.

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Predictive Value of Tests
  • Prospective Studies
  • Pseudotumor Cerebri / diagnostic imaging*
  • Pseudotumor Cerebri / epidemiology*
  • Retrospective Studies
  • Vision Disorders / diagnostic imaging*
  • Vision Disorders / epidemiology*
  • Young Adult