Case reports of neuro-ophthalmological complications of CIPD
Reviewed by Claire Howard

The authors present three cases of neuro-ophthalmological complications of chronic inflammatory demyelinating polyradiculoneuropathy (CIPD). CIPD can lead to prominent nerve hypertrophy which can mimic other forms of neuropathy radiologically. In addition, complications can occur which can cause diagnostic difficulties. All three cases reported have the presence of hypertrophic nerve enlargement. A review of literature for large case series and single case reports shows a small percentage of patients with the disease to have neuro-ophthalmological complications. The neuro-ophthalmological presentation usually occurs following a long history of CIPD. The authors discuss the implication of clinicians being aware of the possibility of CIPD in neuro-ophthalmological presentations, especially if neuro imaging reveals cranial / spinal nerve root hypertrophy or if raised cerebrospinal fluid (CSF) protein is detected. Best treatment for the complications is to treat the underlying condition with appropriate immunosuppression. Other treatment options for refractory papilloedema include acetazolamide, optic nerve sheath fenestration and CSF diversion surgery.

Neuro-ophthalmological complications of chronic inflammatory demyelinating polyradiculoneuropathy.
Hickman SJ, Allen JA, Baisre A, et al.
NEURO-OPHTHALMOLOGY
2013;37(4):146-56.