Abstract
Abstract: :
Purpose: To study the visual outcomes of patients with IIH. Methods: This was a retrospective study of patients who fulfilled the diagnostic criteria for IIH, and who were followed by a neuro–ophthalmologist at the Kresge Eye Institute between 1985 and 2004. Information on demographics, past medical history, medical and surgical treatments, pre– and post–treatment visual acuity, Humphrey 24–2 visual fields, and optic nerve appearance was analyzed. Medical records of 113 patients fulfilling the diagnostic criteria were reviewed, and 34 patients were identified as having at least a 6 month follow–up period. Mean values were calculated for Snellen visual acuity and Humphrey visual field results pre– and post–treatment. Snellen visual acuity was converted to log mar for statistical analysis. Optic nerve appearance was also compared before and after treatment. Results: Overall, 30 patents were treated during follow–up medically, 7 surgically, and 3 never needed treatment. At last follow–up, 14 patients were free from treatment. At baseline, 85% of eyes had 20/40 vision or better. At last follow–up, 96% of eyes had 20/40 vision or better. There was no statistical difference between visual field results pre– and post–treatment. 82% of optic nerves were described as swollen at baseline, whereas, at last follow–up 35% were described as swollen. Conclusions: Our data supports that the majority of patients with IIH, with relatively conservative medical treatment, weight loss, and close follow–up, have generally benign visual outcomes. Patients that presented with poorer visual acuity and/or greater field loss received more surgical treatments and had worse outcomes despite surgical intervention.
Keywords: neuro-ophthalmology: optic nerve • clinical (human) or epidemiologic studies: outcomes/complications • neuro-ophthalmology: diagnosis