Anatomic and visual function outcomes in paediatric idiopathic intracranial hypertension

Gospe, Sidney M.; Bhatti, M. Tariq; El-Dairi, Mays

doi:10.1136/bjophthalmol-2015-307043

Cited by 63 publications

(37 citation statements)

References 26 publications

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“…The high rate of ODD in IIH with resolved papilloedema at almost 10 times higher than expected in the general population suggests that the coexistence of ODD and IIH is not random. Interestingly, a 2016 report from Gospe et al 30 identified 48% (13 of 27) of their pediatric IIH cases having evidence of buried ODD on OCT after papilloedema had resolved. It is uncertain if the development of ODD is more likely to occur when papilloedema from IIH develops in the prepubescent period as compared with an older age of IIH onset.…”

Section: Discussionmentioning

confidence: 99%

Increased Prevalence of Optic Disc Drusen after Papilloedema from Idiopathic Intracranial Hypertension: On the Possible Formation of Optic Disc Drusen

Birnbaum

Johnson

et al. 2016

Neuro-Ophthalmology

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This is a 25-year observational retrospective review of 372 consecutive participants with optic disc drusen or resolved papilloedema from idiopathic intracranial hypertension. The prevalence of optic disc drusen at 19% among eyes with resolved papilloedema was approximately 10 times higher and significantly increased (p < 0.001) as compared with the occurrence in the general population. Eyes with both resolved papilloedema and optic disc drusen had similar visual acuity and visual field outcome as compared with resolved papilloedema alone. Eyes with exposed drusen had significantly worse visual acuity and visual field outcome (p < 0.001) than buried drusen. The high prevalence of optic disc drusen after papilloedema has resolved suggests a non-coincidental relationship. Optic disc drusen formation can be a sequela of papilloedema.ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Increased Prevalence of Optic Disc Drusen after Papilloedema from Idiopathic Intracranial Hypertension: On the Possible Formation of Optic Disc Drusen

Birnbaum

Johnson

et al. 2016

Neuro-Ophthalmology

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“…They found permanent visual acuity or visual field loss in 19% of the children, and highly correlative with vision loss was OCT findings of optic atrophy in 13% and photoreceptor loss in 19% of the children. 59 In an evaluation of 56 children with IIH, Agarwal et al found 17% had poor visual acuity outcome (worse than 20/200 vision) and 41% had poor visual field testing at 6 months. 69 Predictors of permanent vision loss are severe swelling, severe visual field/acuity loss, and high opening pressure at presentation.…”

Section: Discussionmentioning

confidence: 99%

“…69 Predictors of permanent vision loss are severe swelling, severe visual field/acuity loss, and high opening pressure at presentation. 58,59,69…”

Section: Discussionmentioning

confidence: 99%

Update in Pediatric Pseudotumor Cerebri Syndrome

Beres

2020

Semin Neurol

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Pseudotumor cerebri syndrome (PTCS) is a rare condition in children presenting with headache and papilledema from increased intracranial pressure that can cause significant morbidity. This can be idiopathic, also known as idiopathic intracranial hypertension or primary intracranial hypertension, or can be secondary to medications and associated medical conditions. Given the threat to vision, early detection and treatment is needed in all age groups. However, identifying papilledema or pseudopapilledema in children presents unique challenges sometimes as a result of differences between prepubertal and postpubertal children, further elucidating the complex pathophysiology. Management requires brain imaging, lumbar puncture, and frequent eye exams with medical and rarely surgical treatment. Visual outcomes in children are favorable if caught early and management can be prolonged over years. Pediatric PTCS is different from adult PTCS in many ways, and this review will focus on the most updated definitions of the disease, theories of pathophysiology, management, and treatment in the pediatric population.

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“…96,98 Similarly, OCT can be used to diagnose and monitor pediatric pseudotumor cerebri and is potentially useful as a visual prognostic tool in this condition. 99,100 An increased central macular, temporal, and superior RNFL thickness has been described in children affected by pseudotumor cerebri. 101 The presence of optic atrophy and photoreceptor loss on OCT in pseudotumor cerebri are findings that are highly associated with irreversible visual loss.…”

Section: Optic Nerve Pathologymentioning

confidence: 99%

“…101 The presence of optic atrophy and photoreceptor loss on OCT in pseudotumor cerebri are findings that are highly associated with irreversible visual loss. 100 Interestingly, optic nerve parameters may also be predictive of central nervous system development and pathology, with larger vCDR being associated with lower Bayley Scales of Infant Development scores. 28,33 A weak association has been described between a larger vertical cup diameter (vCD) and vCDR with periventricular leukomalacia, and a shallower cup with posthemorrhagic hydrocephalus.…”

Section: Optic Nerve Pathologymentioning

confidence: 99%

Pediatric Optical Coherence Tomography in Clinical Practice—Recent Progress

Lee

Proudlock

Gottlob

2016

Invest. Ophthalmol. Vis. Sci.

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Citation: Lee H, Proudlock FA, Gottlob I. Pediatric optical coherence tomography in clinical practice-recent progress. Invest Ophthalmol Vis Sci. 2016;57:OCT69-OCT79. DOI:10.1167/iovs.15-18825 PURPOSE. Optical coherence tomography (OCT) has revolutionized the diagnosis and management of adult retinal and optic nerve disease. Children were deprived of this technology until the recent development of handheld spectral-domain OCT (HH-SDOCT). In this article, we review the applications of OCT imaging in pediatric ophthalmology.METHODS. This study was a review of the literature.RESULTS. The acquisition and interpretation of pediatric tomograms differ significantly from those for adults, with adjustments needed to account for the shorter axial lengths, higher refractive errors, and ongoing retinal and optic nerve development in the pediatric eye. Handheld SDOCT is increasingly being used as an adjunctive diagnostic tool in retinopathy of prematurity (ROP) and nonaccidental injury (NAI) by providing additional morphologic information that is not normally clinically discernible. The role of HH-SDOCT in streamlining diagnosis in infantile nystagmus syndrome, retinal dystrophies, and degenerations has been established. Optical coherence tomography can also help differentiate between pediatric intraocular tumors, for example, hamartomas and retinoblastoma; monitor tumor progression; and monitor treatment response. In addition, HH-SDOCT is establishing its role as a noninvasive monitoring tool in children affected by optic nerve pathology such as glaucoma, optic nerve atrophy and hypoplasia, optic pathway glioma, and pseudotumor cerebri. CONCLUSIONS.Handheld SDOCT can provide novel insights into the natural history of retinal and optic nerve diseases in young children. For example, in achromatopsia and albinism, in vivo OCT studies have provided evidence of altered but ongoing retinal development in early childhood, which suggests that potentially targeting treatment at an earlier age may optimize visual function by normalizing retinal development.

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Anatomic and visual function outcomes in paediatric idiopathic intracranial hypertension

Cited by 63 publications

References 26 publications

Increased Prevalence of Optic Disc Drusen after Papilloedema from Idiopathic Intracranial Hypertension: On the Possible Formation of Optic Disc Drusen

Increased Prevalence of Optic Disc Drusen after Papilloedema from Idiopathic Intracranial Hypertension: On the Possible Formation of Optic Disc Drusen

Update in Pediatric Pseudotumor Cerebri Syndrome

Pediatric Optical Coherence Tomography in Clinical Practice—Recent Progress

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