Etiological Profile of Bilateral Papillary Edema in Young Subjects at the CHU-IOTA – Bamako

Abstract

Introduction: Papillary edema is the clinical expression of various conditions. This is fluid and/or axonal swelling of the optic nerve head due to blockage of axoplasmic flow at the level of the cribriform plate. The aim of our study was toto assess the etiological aspects of bilateral papillary edema in young subjects and their impact on vision. Patients and Method: This was a 36-month prospective study, January 1, 2018 to December 31, 2020 including all young patients aged 15 to 40 followed for papilledema at CHU-IOTA Bamako. Results: Ninety-four affected eyes were collected in 47 patients, with a female predominance of 76.6%. Our average age was 25.7 years and the sex ratio 0.31. Papillary edema was bilateral in 100% of cases. Stasis papilledema due to intracranial hypertension (ICH) was the most common etiology (91.5%). Intracranial hypertension was idiopathic in 74.5% of cases and secondary in 25.7% of cases. In idiopathic HIC the main risk factor was overweight found in 78.3% of cases (all women) followed by taking oral contraceptives with 21.7% and alcoholism in 7.7%. Secondary HIC resulted from tumor or compressive (55.6%), infectious and cerebral thrombophebitis (22.2%) each. Conclusion: This prospective study including 47 patients for papilledema without obvious cause highlighted the frequency of intracranial hypertension as the main etiology.