This prospective study of 40 patients aims to assess visual morbidity in patients with idiopathic intracranial hypertension (IIH). Final visual outcome of patients was compared with clinical and neuro-ophthalmic parameters such as visual acuity, visual field, contrast sensitivity, retinal nerve fibre layer thickness and visual evoked potentials (VEPs). In univariate analysis, severity of visual loss, cerebrospinal fluid pressures and abnormal VEPs were associated with worse visual outcome or need for aggressive management. Signs such as high cerebrospinal fluid opening pressure, worsening vision / papilledema, greater retinal nerve fibre layer thickness and abnormal VEPs cannot be used as an independent predictor for visual outcome in isolation. Visual loss at presentation is probably the most important predictor of the final visual outcome in these patients. The authors conclude that early diagnosis and management is the main focus of management for these patients.

Clinical and neuro-ophthalmologic predictors of visual outcome in idiopathic intracranial hypertension.
Takkar A, Goyal MK, Bansal R, Lal V.
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Claire Howard

Salford Royal NHS Foundation Trust, Salford, UK.

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