DOI: https://doi.org/10.22263/2312-4156.2016.3.78
Egorova E.S.
Risk factors for the optic nerve secondary atrophy development in patients with idiopathic intracranial hypertension
State Establishment «Institute of neurosurgery named after the academician A.P. Romodanov of the Ukrainian NAMS», Kiev, Ukraine
Vestnik VGMU. 2016;15(3):78-83.
Abstract.
Objectives. To study risk factors for the development of secondary optic nerve atrophy (SONA) in idiopathic intracranial hypertension (IIH).
Material and methods. The neuroophthalmological study was conducted in 50 patients (100 eyes) with IIH before and after treatment in the period from 2000 to 2014.
Results. Local and systemic risk factors were analyzed, i.e. biological parameters, systemic diseases, patients’ complaints and duration of the disease. Severe loss of vision (visual acuity and / or visual field) was observed in 17 patients, moderate loss – in 22 patients. The duration of the disease up to 6 months was noted in 31 patients (62 eyes), more than 6 months – in 19 patients (38 eyes). As a result of the provided treatment (medicinal – in 10 patients and neurosurgical – in 40 patients) severe loss of vision remained in 15 patients, moderate one – in 9 patients. Arterial hypertension and the duration of the disease for more than 6 months turned out to be the most significant risk factors for the development of severe vision loss with the subsequent SONA.
Conclusions. Visual disturbances in IIH are manifested by visual acuity loss and visual field defects. The dependence on the duration of the disease and the development of SONA testifies to the importance of early diagnosis in order to decrease the degree of severe vision loss in this pathology.
Key words: idiopathic intracranial hypertension, secondary atrophy, factors, risk.
References
1. Friedman DI, Jacobson DM. Diagnostic criteria for idiopathic intracranial hypertension. Neurology. 2002 Nov;59(10):1492-5.
2. Degnan AJ, Levy LM. Pseudotumor cerebri: Brief Review of Clinical Syndrome and Imaging Findings. AJNR Am J Neuroradiol. 2011 Dec;32(11):1986-93.
3. Binder DK, Horton JC, Lawton MT, McDermott MW. Idiopathic intracranial hypertension. Neurosurgery. 2004 Mar;54(3):538-51.
4. Monteiro MLR, Moura FC. Aspectos oftalmológicos da síndrome da hipertensão intracraniana idiopática (pseudotumor cerebral). Rev Bras Oftalmol. 2008 Jul-Aug;67(4):196-203.
5. Bright P, red. Neuroimaging – Clinical Applications [Internet]. Rijeka, Croatia: InTech; 2012. Capter 17, Rosenfeld E, Kesler A. Pseudotumor cerebri (idiopathic intracranial hypertension) an update. [cited 2016 May 19]. Available from: http://cdn.intechopen.com/pdfs-wm/31420.pdf.
6. Hannerz J, Ericson K. The relationship between idiopatic intracranial hypertension and obesity. Headache. 2009 Feb;49(2):178-84.
7. Wall M. Idiopathic intracranial hypertension. Neurol Clin. 2010 Aug;28(3):593-617.
8. Yri HM, Wegener M, Sander B, Jensen R. Idiopathic intracranial hypertension is not benign: a long-term outcome study. J Neurol. 2012 May;259(5):886-94.
Information about authors:
Egorova E.S. – neuroophthalmologist, State Establishment «Institute of Neurosurgery named after the academician A.P. Romodanov of the Ukrainian NAMS», Ukraine.
Correspondence address: Ukraine, 04050, Kiev, 32 Platona Mayborody (Maniulskogo) str., State Establishment «Institute of Neurosurgery named after the academician A. P. Romodanov of the Ukrainian NAMS». E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Egorova E.S.