Pediatric Papilledema at a Tertiary Care Ophthalmological Center

Maheswaran, Murugesan; Dheera, Mulasthanam Sai; Kumar, Mahesh; Kowsalya, Akkayasamy

doi:10.1007/s13312-020-2006-4

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…When symptoms were reported, headache was most commonly reported followed by visual disturbances, consistent with prior studies. 4 , 5 , 7 However, 56 children in our study were asymptomatic at presentation. Despite the lack of symptoms, 41% of asymptomatic patients were diagnosed with papilledema.…”

Section: Discussionmentioning

confidence: 63%

“…However, optic nerve head elevation may also be a sign of vision- or life-threatening conditions such as elevated intracranial pressure (ICP), idiopathic intracranial hypertension (IIH) or intracranial tumors. 1–4 Although headache, nausea and/or visual disturbances can be present, children may be asymptomatic or fail to report symptoms 5 , 6 and thus symptoms cannot be relied upon to conclusively determine the etiology. Given the potential vision- and life-threatening conditions that can cause optic nerve head elevation, this study aims to identify the demographic trends, clinical characteristics, and diagnostic outcomes of this finding in children presenting to an ophthalmology emergency department (ED).…”

Section: Introductionmentioning

confidence: 99%

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Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation

Cavuoto¹,

Markatia²,

Patel³

et al. 2022

OPTH

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Objective Optic nerve head elevation may be the only clinical sign of a vision- and/or life-threatening condition, particularly in children who are asymptomatic or fail to report symptoms. The purpose of this study is to identify epidemiologic trends, clinical characteristics, and diagnostic outcomes of pediatric patients presenting to an ophthalmology emergency department (ED) with suspected optic nerve head elevation. Methods This retrospective study identified pediatric patients (≤18 years) presenting to an ophthalmology ED over a five- year period with suspected optic nerve head elevation to describe demographic trends, clinical characteristics, and diagnostic outcomes. Results Of the 213 patients, the majority were female (73.2%) and tended to be older than males (14.3 vs 11.2 years, p<0.001). The most common diagnoses were papilledema (52.6%), pseudopapilledema (31.5%), and optic nerve drusen (8.0%). When symptoms were present, most (73.7%) patients presented with headache (67.5%) or visual disturbance (54.8%). Of 144 neuroimaging studies obtained, 80 (55.6%) had positive findings and these were significantly associated with symptoms at presentation (p=0.017) and age (p=0.034), but not sex (p=0.791). Asymptomatic females and children >12 years old were more likely to have an abnormal MRI than males and children ≤ 12 (OR=1.56 and 1.22, respectively). Conclusion Patient demographics such as age and sex in conjunction with concurrent symptoms are important factors in determining the urgency of neuroimaging in children with suspected optic nerve head elevation.

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Section: Discussionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation

Cavuoto¹,

Markatia²,

Patel³

et al. 2022

OPTH

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“…Regarding etiology, there have been some studies investigating which disease entities are prominent in patients with papilledema. Accordingly, PTC has been identified as one of the main causes of existing papilledema in adults ( Crum et al, 2020 ), and children ( Maheswaran et al, 2020 ). Hyde et al reported, that most of the children presenting with papilledema had PTC (42.1%) or tumor (15.8%) ( Hyde et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Influence of sex and disease etiology on the development of papilledema and optic nerve sheath extension in the setting of intracranial pressure elevation in children

Kerscher,

Tellermann,

Zipfel

et al. 2024

Brain and Spine

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“…Further, there are only a few recent studies on the evaluation of cost of stay in public and private sectors. [10][11][12][13][14][15][16] Adjusting to cost of inflation over period of time, 17 the average cost of care per patient per day was estimated to be US$203 in Chandigarh (2003) 10 and US$157.2 in Delhi (2010) in public sector NICUs 11 and US$407 in a for-profit private sector NICU was US$ 272.4. 12 Different authors have used different models to estimate the cost of care, had varying sample size, used diverse inclusion criteria, and also gauged total running cost of NICU.…”

Section: Discussionmentioning

confidence: 99%

Financial Implications for Families of Newborns Admitted in a Tertiary Care Neonatal Unit in Northern India

Gautam

Singh

Verma

et al. 2023

Journal of Neonatology

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Background Admission of a newborn to neonatal intensive care unit is very stressful for family and poses significant financial burden. Aim To estimate the cost of neonatal care in a tertiary care level institution in northern India. Methods This prospective observational study was conducted over a period of 4 months at a 30-bedded level III neonatal unit in a tertiary care institute in north India. Data was collected from a self-written diaries by parents of all neonates admitted in the unit. The cost analysis included direct hospital cost and additional expenditure by families during entire hospital stay. Results A total of 135 newborns (86 males) were enrolled in this study. 60 babies required Neonatal intensive care unit (NICU) admission. The median total expenditure incurred in study cohort was US$172 (IQR 83.5–546.3); median duration of hospital stay was 7 (IQR 5–16) days. The total expenditure per day for babies with Neonatal intensive care unit stay was US$32.7 (IQR 23.5–48). The direct hospital charges amounted to approximately 3/4th of total expenditure, while rest 1/4th was additional cost incurred upon family. Conclusion The cost of care of a sick newborn in public sector hospital of India is substantial. Additional expenditure apart from direct cost of treatment contributes significantly to the financial burden.

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Pediatric Papilledema at a Tertiary Care Ophthalmological Center

Cited by 6 publications

References 6 publications

Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation

Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation

Influence of sex and disease etiology on the development of papilledema and optic nerve sheath extension in the setting of intracranial pressure elevation in children

Financial Implications for Families of Newborns Admitted in a Tertiary Care Neonatal Unit in Northern India

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