Abstract
Objective
Idiopathic intracranial hypertension (IIH) is defined as elevated intracranial pressure
(ICP) with normal cerebrospinal fluid content in the absence of an identifiable cause.
Patients often experience symptoms related to elevated ICP (e.g., headache); however,
a subgroup of patients with elevated ICP may have optic disc edema without any associated
symptoms. There are limited data about this subgroup in the literature. Our aim in
this study was to characterize the initial clinical findings and visual outcomes over
the follow-up period in this group of asymptomatic patients.
Methods
We performed a retrospective review of all patients who were referred to the neuro-ophthalmology
service at Baylor College of Medicine for evaluation of papilledema between January
2012 and June 2020. Medical records of 139 consecutive patients with papilledema were
reviewed. Patients were included in the analysis if they met the criteria for the
diagnosis of IIH, had bilateral optic disc edema, and did not have any symptoms of
elevated ICP.
Results
Of the 139 charts reviewed, 5 patients met the inclusion criteria. All 5 patients
were female with a mean age of 25.2 years (range, 13–48 years). The mean body mass
index was 36.3 kg/m2 (range, 31.5–40 kg/m2), and the mean follow-up period was 3 years (range, 12 months–5 years).
Conclusion
Our results demonstrate that the disease course for patients who present with asymptomatic
IIH can be variable, yet still visually significant. Despite the absence of symptoms,
patients can progress to symptomatic disease or experience persistent optic disc swelling
or pallor even with the use of medication to lower ICP. To our knowledge, this is
the first retrospective study characterizing the clinical course of papilledema from
IIH in asymptomatic individuals.
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Article Info
Publication History
Published online: March 16, 2022
Accepted:
February 19,
2022
Received in revised form:
January 28,
2022
Received:
October 10,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
