Relationship of Opening CSF Pressure and Visual Field Defect in Idiopathic Intracranial Hypertension

Sepideh Paybast,Farhad Assarzadegan,Mohsen Koosha,Behnam Safarpoor Lima

doi:10.15171/icnj.2018.10

Sepideh Paybast, Farhad Assarzadegan + Show 2 more

Open Access

https://doi.org/10.15171/icnj.2018.10

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Abstract

Background: Idiopathic intracranial hypertension (IIH) is an increased intracranial pressure with normal cerebrospinal fluid (CSF) characteristic in the absence of identifiable causes. The most important complication of this disorder is visual impairment. So far, no comprehensive study has been done on the relationship between the opening CSF pressure and visual field defect in IIH. Methods: In this study, 35 patients with increased intracranial pressure who fulfilled modified Dandy’s criteria underwent ophthalmologic examination and lumbar puncture. The opening CSF pressure was categorized into mild (25-30), moderate (30-40) and severe (>40). The degree of visual field defect was reported both quantitatively and qualitatively. Eventually, the statistical relationship was established among these variables. Results: The mean opening CSF pressure was 33.71 CmH2o. Twelve patients had minor CSF pressure, whereas in 14 and 9 patients the CSF pressure was respectively moderate and severe. There was not statistically significant relationship between the visual field defect and CSF pressure. The most common patterns of visual field involvement were enlarged blind spot and peripheral restriction. Conclusion: The most important morbidity in IIH is visual impairment. According to the findings, the visual field impairment is not pertinent to CSF pressure. In other words, neither high CSF pressure predicts intense visual defect, nor low CSF pressure indicates minimal visual impairment.

Highlights

Idiopathic intracranial hypertension (IIH) is a challenging disorder of intracranial hypertension in the absence of an intracranial mass, hydrocephalus, or other identifiable cause
IIH has a variable course ranging from a short benign self-limiting syndrome to more aggressive syndromes that proceed to blindness in a short period of time.[5,6,7]
Inadequate research has been done on the relationship of cerebrospinal fluid (CSF) pressure and visual field defect

Summary

Introduction

Idiopathic intracranial hypertension (IIH) is a challenging disorder of intracranial hypertension in the absence of an intracranial mass, hydrocephalus, or other identifiable cause. The incidence is approximately 0.9/100.000/year rising to 13/100.000/year in overweight women between 20 and 44 years of age Less frequently, it is seen in children and overweight men.[1,2,3,4,5] Due to increasing prevalence of the obesity over the last years, IIH has been on the rise. Idiopathic intracranial hypertension (IIH) is an increased intracranial pressure with normal cerebrospinal fluid (CSF) characteristic in the absence of identifiable causes. No comprehensive study has been done on the relationship between the opening CSF pressure and visual field defect in IIH. There was not statistically significant relationship between the visual field defect and CSF pressure.

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Results

Conclusion