Analysis of the Ophthalmological Manifestations of Diagnosed Cases of Idiopathic Intracranial Hypertension

Abstract

Purpose: The purpose of this study was to explore the ophthalmological involvement in diagnosed cases of Idiopathic Intracranial Hypertension (IIH). Methods: Case series of all patients diagnosed with IIH from October 2012-2014 at the Neurology Department of Amrita Institute of Medical Sciences were prospectively analysed. Analysis was done for 35 patients who fulfilled the updated diagnostic criteria. Results: 80% of the patients were women with a mean age of 34.5. The chief complaint was a throbbing headache in 85.7%.The least common complaints were tinnitus, phonophobia, and photophobia, and one patient had right facial paresis. All patients had well-preserved visual acuity. 30 patients had normal extraocular movements, bilateral abduction restriction was found in 4 patients, and one was reported to be with third and sixth nerve paresis. 22 patients were in Obese class I. CSF opening pressure was elevated in all patients. 80% had Grade 1 papilledema. Enlargement of blindspot and peripheral constriction of fields were commonly seen. 41.4% of patients showed inferior RNFL thickness to be the most affected. A statistically significant association was found between the grade of papilloedema and the visual field. Conclusion: All our patients had papilledema clinically, with well-preserved central vision. Visual field defects were found, which showed a positive correlation with the severity of papilledema, showing the visual field to be a sensitive indicator. Contrary to expectation, an increase in RNFL on OCT was not a universal finding in our patients despite clinically observable papilledema.