Pathogenesis and Evaluation of the Effects of Idiopathic Intracranial Hypertension on the Optic Nerves

Elsaid, Nada; Ahmed, Omar T.; Belal, Tamer; Razek, Ahmed Abdel Khalek Abdel; Azab, Ahmed

doi:10.1080/01658107.2020.1751859

Cited by 9 publications

(11 citation statements)

References 41 publications

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“…Papilledema is a known phenomenon in conditions involving high ICP, and is related to the transmission of high ICP to the optic disc through the optic sheath that surrounds the subarachnoid space. Chronic venous engorgement also contributes to this high pressure [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…It may seem obvious that elevation of the intracranial pressure (ICP) induces papilledema, which in turn causes visual deterioration. However, the pressure-induced effect on the retrobulbar optic nerve (ON) may play a role in visual disturbances [ 4 - 7 ]. There are non-specific findings on routine magnetic resonance (MR) imaging for the diagnosis of IIH.…”

Section: Introductionmentioning

confidence: 99%

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Combined accuracy of optic nerve sheath diameter, strain ratio, and shear wave elastography of the optic nerve in patients with idiopathic intracranial hypertension

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Combined accuracy of optic nerve sheath diameter, strain ratio, and shear wave elastography of the optic nerve in patients with idiopathic intracranial hypertension

et al. 2022

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“…Although optic nerve compression is the commonly accepted contributing pathology of visual deterioration in cases of IIH [ 21 ], the present study’s findings give an imperative perspective to the outer retinal involvement that might complicate the course of IIIH, evidenced by the mfERG results. Distinguishing outer retinal changes from optic neuropathy as the cause of visual deterioration is decisive because outer retinal changes in the macula could often be reversible [ 3 , 22 ].…”

Section: Discussionmentioning

confidence: 73%

Neurophysiological visual assessment in patients with idiopathic intracranial hypertension: visual evoked potential and multifocal field electroretinography

et al. 2023

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Background Determining the cause of visual deterioration in idiopathic intracranial hypertension (IIH) patients is of clinical necessity. This study aimed to study the effect of chronic increased ICP on the retina and optic nerve through objective electrophysiological measures in chronic IIH patients. Methods Thirty patients with chronic IIH and thirty age and sex-matched healthy controls were included in this study. Papilledema grade and CSF pressure were evaluated in the patients’ group. Both groups were submitted to visual evoked potentials (VEP) and multifocal electroretinogram (mfERG). Result The mean value of P100 latencies of the right and left on two check sizes, 1 deg and 15ṁ in chronic IIH patients, was significantly delayed than controls (P-value < 0.001 for each). Chronic IIH patients showed a significantly lower amplitude of the right and left R1, R2, R3, R4 & R5 compared to controls (P-value < 0.001, < 0.001) (P-value < 0.001, < 0.001) (P-value < 0.001, < 0.001) (P-value < 0.001, = 0.001) (P-value = 0.002, < 0.001), respectively. Also, patients showed a significantly delayed peak time of the right and left R1 and R2 compared to controls (P-value < 0.001, < 0.001) (P-value = 0.001, = 0.009), respectively. There was a significant positive correlation between each of CSF pressure and papilledema grade with right and left PVEP latencies. In contrast, there was no statistically significant correlation between either CSF pressure or papilledema grade and PVEP amplitudes in both eyes. Conclusion In chronic IIH patients, both optic nerve dysfunction and central retinal changes were identified, supported by VEP and the mfERG findings.

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“…the measurement after the administration of CSEA, was significantly higher than the IOP value at T0 (P < 0.01), whereas the IOP values were similar at T3, T4, and T0 for both eyes (P > 0.05) (Table 1). 3 A comparison of the RIGHT intraocular pressure between the GA and CSEA groups 4 A comparison of the LEFT intraocular pressure between the GA and CSEA groups Open access attribution (CC BY-NC 4.0) eyes at T0; i.e. the baseline measurement (P > 0.05).…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, increased IOP can be observed due to increased central retinal venous pressure when sections of the optic nerve and retinal veins located in the subarachnoid space are compressed. 3,4 IOP is also affected by the central effect of general anesthetics, the effect of muscle relaxants on extraocular muscles and to adrenergic reflexes to laryngoscopy and intubation. 5 In lower extremity surgeries, tourniquets are frequently used to reduce blood loss and create a bloodless surgical field.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the effects of general anesthesia and combined spinal-epidural anesthesia on intraocular pressure in lower extremity surgeries employing pneumatic tourniquets: a randomized clinical trial

Yildiz¹,

Güleç²,

Ozayar³

et al. 2023

Anaesth. pain intensive care

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Background & Objective: Induction of general anesthesia has been known to raise the intraocular pressure (IOP). The effect is more pronounced at the time of intubation. Similarly, applying pneumatic tourniquets is associated with rise in IOP. We compared the effects of general anesthesia and combined spinal-epidural anesthesia (CSEA) on IOP in lower extremity surgeries employing pneumatic tourniquets. Methodology: A total of 50 patients, aged over 18 y, completed the study. Patients were randomly divided into the general anesthesia group (Group GA) and CSEA group (Group CSE). IOP and hemodynamic parameters including systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and heart rate (HR),were measured at baseline (T0), and after general anesthesia induction (T1), after intubation or after initiation of CSEA (T2), after placement of tourniquet (T3), and on removal of tourniquet (T4). Results: There was no difference in IOP between the groups at T0 (P > 0.05), but it was higher at T2, T3, and T4 in Group CSE than in Group GA (P < 0.05). SAP was only higher in Group CSE at T3 (P < 0.05). İn Group GA IOP at T1, T3, and T4 was lower than that at T0 (P < 0.01) but were similar at T2 and T0 (P > 0.05). SAPs at T1, T3, and T4 were lower than those at T0 (P < 0.05) but were similar to those at T2 and T0 (P > 0.05). İn Group CSE although SAP was lower at T2, T3, and T4 than that at T0 (P < 0.05), IOP at T2 was higher than that at T0 (P < 0.01). IOP was the same at T3, T4, and T0 (P > 0.05). Abbreviations: IOP: intraocular pressure; CSEA: combined spinal-epidural anesthesia; SAP: systolic arterial pressure; DAP: diastolic arterial pressure; MAP: mean arterial pressure Key words: Intraocular Pressure; Anesthesia, Spinal; Anesthesia, General; Anesthesia, combined spinal-epidural; Tourniquet Citation: Yildiz G, Gulec H, Ozayar E, Horasanli E. Comparison of the effects of general anesthesia and combined spinal-epidural anesthesia on intraocular pressure in lower extremity surgeries employing pneumatic tourniquets: a randomized clinical trial. Anaesth. pain intensive care 2023;27(1):09−15 DOI: 10.35975/apic.v27i1.2135 Received: December 17, 2020; Reviewed: January 27, 2021; Accepted: March 18, 2021

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Pathogenesis and Evaluation of the Effects of Idiopathic Intracranial Hypertension on the Optic Nerves

Cited by 9 publications

References 41 publications

Combined accuracy of optic nerve sheath diameter, strain ratio, and shear wave elastography of the optic nerve in patients with idiopathic intracranial hypertension

Combined accuracy of optic nerve sheath diameter, strain ratio, and shear wave elastography of the optic nerve in patients with idiopathic intracranial hypertension

Neurophysiological visual assessment in patients with idiopathic intracranial hypertension: visual evoked potential and multifocal field electroretinography

Comparison of the effects of general anesthesia and combined spinal-epidural anesthesia on intraocular pressure in lower extremity surgeries employing pneumatic tourniquets: a randomized clinical trial

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