This is a report of a review of optic disc photographs, of the type and frequency of the optic disc haemorrhages (ODH), papilloedema grades and other fundoscopic abnormalities at baseline. In the study eyes of 133 patients enrolled in the diopathic Intracranial Hypertension (IIH) Treatment Trial with six months follow-up, 22.7% had nerve fibre layer haemorrhages (NFLH). Five of seven patients, 71% of the subjects that met the criteria of treatment failure, had NFLH in at least one eye (p=0.02). There was a good correlation between presence of the NFLH and Frisen grade (p=0.002, r=0.271 Spearman’s correlation). Subjects with NFLH had a higher cerebrospinal fluid (CSF) pressure (40.0 mm water, p=0.04). Cotton wool spots were present in 4%, exudates in 3% and pseudodrusens in 4% of the subjects. The authors concluded that NFLHs are common in patients with IIH with mild visual loss and correlate with the severity of the papilloedema. They also occur more frequently in treatment failure subjects and maybe associated with poor visual outcomes.

Optic disc haemorrhages at baseline as a risk factor for poor outcome in the Idiopathic Intracranial Hypertension Treatment Trial.
Wall M, Thurtell MJ; NORDIC Idiopathic Intracranial Hypertension Study Group.
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Jonathan Chan

Royal Hallamshire Hospital, Sheffield, UK.

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