Background: Once thought benign, IIH is now recognized as a potentially vision devastating entity. Predictors of worse outcome may aid in appropriate management of patients of IIH.
Objective: To assess visual morbidity in patients of IIH in terms of clinical and neuro-ophthalmologic parameters.
Methods: In a prospective study of 40 patients of IIH, clinical and neuro-ophthalmologic parameters were noted. All parameters were graded using objective criteria and compared with final visual outcome of patients to determine any correlation.
Results: Presence of headache and transient visual obscurations (TVOs) at presentation was significantly associated with good visual outcome. Higher CSF opening pressure, Increased Retinal nerve fibre layer (RNFL) thickness (>178 μm) on optical coherence tomography, abnormal contrast sensitivity at high frequency and prolonged P100 latency on visual evoked potential (VEP) were associated with poor visual outcome. No definite correlation between presence of cranial nerve palsies, other clinical features, obesity, grade of papilledema and findings on neuroimaging with final visual outcome was established.
Conclusion: Visual Outcome in patients of IIH can be predicted at presentation by various parameters providing window for early and adequate treatment. High Body mass index, high CSF opening pressure, greater RNFL thickness, abnormal VEP or contrast sensitivity are some of the alarming signs for physicians necessitating need for aggressive monitoring and management. On the contrary, presence of headache or TVOs at presentation may predict a better visual outcome. Close follow up of the patients with respect to the neuro-ophthalmologic parameters as described may help in segregating the potential candidates for aggressive management early in the disease course.
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© 2015 Published by Elsevier Inc.
