Early recognition, evaluation and treatment may prevent blindness in giant cell arteritis

Schiffman, Jade S.; Scherokman, Barbara; Lopez-Gurrola, Maria; Marín, Diego; Tang, Rosa A.

doi:10.1586/17469899.2.2.299

Cited by 3 publications

(7 citation statements)

References 62 publications

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“…However, most complications are transient and considered benign in comparison to the vision-threatening nature of IIH (8). Overall, Schiffman et al (46) suggested that ONSF may be the most appropriate surgical intervention for pregnant patients with IIH because there are less follow-up complications compared with shunting.…”

Section: Disease Entitymentioning

confidence: 99%

Surgical Management of Idiopathic Intracranial Hypertension in Pregnancy

Karimaghaei

Raviskanthan

Karimaghaei

et al. 2022

Journal of Neuro-Ophthalmology

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Section: Disease Entitymentioning

confidence: 99%

Surgical Management of Idiopathic Intracranial Hypertension in Pregnancy

Karimaghaei

Raviskanthan

Karimaghaei

et al. 2022

Journal of Neuro-Ophthalmology

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“…The primary causes of this swelling are similar to those in non-pregnant individuals, except for the association with eclampsia/preeclampsia, which we will describe in a separate subchapter. Two conditions, idiopathic intracranial hypertension and cerebral venous thrombosis, are notably more prevalent in pregnant patients than in the general non-pregnant population [6,8,24].…”

Section: Papilledema and Pregnancymentioning

confidence: 99%

“…Pregnant women displaying papilledema should have their blood pressure checked to rule out preeclampsia. Following the exclusion of preeclampsia, a contrast-free MRI examination (after 18 weeks) should be conducted, followed by cerebrospinal fluid analysis if not contraindicated [6,8,19,24].…”

Section: Papilledema and Pregnancymentioning

confidence: 99%

“…Steroids carry unwanted side effects like weight gain, hyperglycemia, and fetal developmental disturbances; hence, they are only indicated in acute situations to treat significant visual decline. Should surgical intervention be required to prevent vision loss during pregnancy, it might entail multiple lumbar punctures or procedures for cerebrospinal fluid shunting [19,[24][25][26][27]. The prognosis for individuals developing IIH during pregnancy is excellent as long as there is clinical and medical monitoring and timely surgical interventions to prevent visual impairment [24].…”

Section: Papilledema and Pregnancymentioning

confidence: 99%

“…Should surgical intervention be required to prevent vision loss during pregnancy, it might entail multiple lumbar punctures or procedures for cerebrospinal fluid shunting [19,[24][25][26][27]. The prognosis for individuals developing IIH during pregnancy is excellent as long as there is clinical and medical monitoring and timely surgical interventions to prevent visual impairment [24].…”

Section: Papilledema and Pregnancymentioning

confidence: 99%

See 2 more Smart Citations

A Narrative Review on Neuro-Ophthalmological Manifestations That May Occur during Pregnancy

Anton,

Bogdănici,

Branișteanu

et al. 2024

Life

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Aim: As a medical condition, pregnancy mandates the simultaneous treatment of both the mother and the fetus, making it a distinctive aspect of clinical medicine. Material and Method: We analyze the physiological changes occurring in the eyes and brain during pregnancy, as well as the neuro-ophthalmological manifestations that can occur during pregnancy. Studies published in both English and other languages, case reports, and reviews from 2011 to 2023 onwards were included. All surveys were acquired by exploring the databases. Results: We found a total of 2135 articles that showcase neuro-ophthalmic changes related to pregnancy: review and research articles (Science Direct 804, Web of Science 923, Scopus 345, and 63 Pub Med). In total, 86 studies were examined after applying the inclusion and exclusion criteria. Bilateral papilledema can be a warning sign for intracranial hypertension or cerebral venous sinus thrombosis. Additionally, when unilateral, it is important to differentially diagnose anterior ischemic optic neuropathy secondary to a hypercoagulant, compressive or inflammatory optic neuropathy, optic neuritis, or even orbital pseudotumor state. Severe eclampsia and preeclampsia can manifest as choroidal infarction, serous retinal detachment, and even cortical blindness. There can also be implications at the level of cranial nerves or transient Horner syndrome. Conclusions: Evaluating and treating a pregnant woman with neuro-ophthalmological manifestations is challenging. The obstetrician closely follows and has a medical relationship with the pregnant woman; hence he/she might be the first to be informed about the general condition of the pregnant woman or might request an ophthalmologic examination tailored to each specific case.

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Idiopathic Intracranial Hypertension Papillopathy due to Hormonal Changes during Pregnancy

Mafrici¹,

Tona

Fragiotta³

et al. 2023

Case Reports in Ophthalmological Medicine

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Background. The underlying mechanisms of papilledema associated with intracranial hypertension remain unclear. A case of bilateral papillary edema in a patient with chronic idiopathic intracranial hypertension who was asymptomatic during her two pregnancies is reported. Case Presentation. A 19-year-old Caucasian female, in her third month of pregnancy, complained of difficulties with close reading. The patient’s visual acuity was 20/20 on the Snellen chart and improved with a 0.50 D correction in both eyes. Near vision and slit lamp examinations revealed normal findings bilaterally. However, a fundus examination showed bilateral papillary edema without evidence of hemorrhages or neovascularization. Blood tests were unremarkable, except for a slight increase in C-reactive protein levels. The patient had a prepregnancy weight of 63 kilograms, with a BMI of 24.91 kg/m2. Magnetic resonance imaging of the brain revealed features consistent with chronic idiopathic intracranial hypertension, which resolved after delivery. Two and a half years later, during a subsequent pregnancy, the patient experienced a recurrence of bilateral papillary edema due to the IIH. It was managed similarly as the first occurrence, resulting in bilateral anatomical and functional recovery. Recent research revealed that, during pregnancy, hormones interact with the central nervous system, leading to an increase in the size of neurons which could potentially result in intracranial hypertension. Conclusions. The influence of hormonal fluctuations during pregnancy on the development of transient central nervous system abnormalities in individuals with chronic intracranial hypertension, leading to papillary edema, remains a matter of debate.

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Early recognition, evaluation and treatment may prevent blindness in giant cell arteritis

Cited by 3 publications

References 62 publications

Surgical Management of Idiopathic Intracranial Hypertension in Pregnancy

Surgical Management of Idiopathic Intracranial Hypertension in Pregnancy

A Narrative Review on Neuro-Ophthalmological Manifestations That May Occur during Pregnancy

Idiopathic Intracranial Hypertension Papillopathy due to Hormonal Changes during Pregnancy

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