Abstract
Objective
The purpose of this study was to report the clinical characteristics and long-term
visual outcomes in a cohort of children with idiopathic intracranial hypertension
(IIH).
Design
Retrospective, observational cohort study.
Participants
Consecutive children who met the diagnostic criteria for definite IIH at a tertiary
care pediatric hospital between 2009 and 2020.
Methods
The charts of pediatric patients with IIH were reviewed. The main outcome measure
was long-term visual impairment, with an analysis of clinical features by age and
risk factors for a poor visual outcome.
Results
There were 110 children (75 females) with IIH. At presentation, younger children with
IIH were less likely to present with headaches (p = 0.01) and more likely to be asymptomatic (p = 0.03). There was a strong association with female sex (p < 0.001) and higher body mass index (p < 0.001) in adolescents in comparison to younger children. Of the 90 patients with
long-term visual outcome data, only 8 (9%) had evidence of mild visual impairment
(1 loss of visual acuity, 7 loss of visual field) with no cases of severe visual impairment.
On risk factor analysis, the only variable associated with a poor visual outcome was
greater severity of papilledema at diagnosis.
Conclusions
In this large series of pediatric IIH, the long-term visual outcomes were favourable,
with evidence of mild visual impairment in less than 10% of patients.
Objectif
Notre étude avait pour objectif de décrire les caractéristiques cliniques et les résultats
visuels à long terme chez des enfants présentant une hypertension intracrânienne idiopathique
(HII).
Nature
Étude de cohorte et d'observation rétrospective.
Participants
Enfants consécutifs qui répondaient aux critères diagnostiques d'HII certaine dans
un hôpital de soins tertiaires pour enfants entre 2009 et 2020.
Méthodes
On a procédé à un examen des dossiers médicaux d'enfants présentant une HII. Les anomalies
visuelles à long terme constituaient le principal paramètre de mesure; on a également
réalisé une analyse des caractéristiques cliniques en fonction de l’âge et des facteurs
de risque de résultats visuels médiocres.
Résultats
On a recensé 110 enfants (dont 75 filles) qui présentaient une HII. À la visite initiale,
les enfants plus jeunes étaient moins susceptibles de souffrir de céphalées (p = 0,01) et plus susceptibles d’être asymptomatiques (p = 0,03). Il y avait un lien étroit entre le sexe féminin (p < 0,001) et un indice de masse corporelle plus élevé (p < 0,001) chez les adolescents, comparativement à ce que l'on a observé chez les enfants
plus jeunes. Sur les 90 patients pour lesquels on disposait de données visuelles à
long terme, seuls 8 patients (9 %) présentaient des signes d'un léger trouble visuel
(diminution de l'acuité visuelle chez un patient et réduction du champ visuel chez
7 patients); aucune anomalie visuelle prononcée n'a été enregistrée. L'analyse des
facteurs de risque a mis au jour une seule variable associée à des résultats visuels
médiocres, soit la présence d'un œdème papillaire dont la gravité était plus prononcée
au moment du diagnostic.
Conclusions
Au sein de cette importante cohorte d'enfants présentant une HII, les résultats visuels
à long terme étaient favorables : en effet, moins de 10 % des patients avaient des
signes d'une légère anomalie visuelle.
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Article info
Publication history
Published online: July 17, 2021
Accepted:
June 15,
2021
Received in revised form:
May 20,
2021
Received:
April 1,
2021
Footnotes
The abstract has been accepted for presentation at the 2021 Virtual Meeting of the American Association of Pediatric Ophthalmology and Strabismus (AAPOS).
Identification
Copyright
© 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
