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Category: Volume 08 Issue 03 March 2020
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Title: Study of Ophthalmic Profile and Prognosis in patients of Idiopathic Intracranial Hypertension

Authors: Dr Prof. Preeti Rawat, Dr Shikha Kudape, Dr Prof. Vijay Bhaisare

 DOI: https://dx.doi.org/10.18535/jmscr/v8i3.79

Abstract

   

Aim: To study the ophthalmic profile of Idiopathic intracranial hypertension and correlation between ophthalmic profile with demographic, clinical and investigation profile as available from department of Medicine /Neurology.

Material and Methods: This study was a Prospective and Retrospective observational study conducted in 30 cases in whom diagnosis of IIH has been made according to Dandys criteria in Upgraded Department of Ophthalmology in MGMMC & MY Hospital during March 2018 to March 2019.

Results: Most (24/30, 80%) of the patients were females and the mean age of presentation was 31years. Chief complaints were headache in all 30 (100%) patients, 17 (56.6%) patients had blurring of vision, 1 (3.3%) patient had diplopia. There is no relation between high BMI and occurrence of IIH as in this study 90% patients has normal BMI. Papilloedema was seen in all 30 (100%) cases, 13(43.5%) patients had enlarged blind spot as the common visual field defect. 93.3% of eyes improved vision between 6/12-6/6, 3.33% of eyes has vision between 6/24-6/12 and visual acuity of rest 3.33% of eyes were remain <6/60 even after treatment. Majority of patients(43.3%) presented with GRADE 1 papilloedema followed by  GRADE 2 in 33.3% , GRADE 3 in 16.6% and GRADE 4 in 6.6% patients. Papilloedema resolved (GRADE 0) in 90% of patients following treatment. 1 Patient had grade 1 papilloedema and 2 patients had deterioration with GRADE 4 Papilloedema after treatment. 7 patients (23%) became asymptomatic, including normalized vision, at 7th day of follow-up and after 3 months 28 patient (93%) improved, except 2 patient which showed visual deterioration even after 3 month of complete treatment.

Conclusions: IIH represents an increasing burden to public health in our country. In this study it is found that medical treatment in early stage (relatively good visual acuity, early disc edema, and normal / minimal field defect) has prevented them from ending up with irreversible vision loss and optic atrophy. A strong suspicion of idiopathic intracranial hypertension in chronic severe headache and immediate investigation followed by proper treatment can salvage vision of patient even in case of established papilloedema. The goal of this study is to delineate the clinical course of this disorder with an emphasis on visual prognosis.

Keywords: Idiopathic intracranial hypertension, Papilloedema, pseudotumorcerebri.

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Corresponding Author

Dr Shikha Kudape

Junior Resident, Department of Ophthalmology, Mahatma Gandhi Memorial Medical College, Indore (M.P.)