Patterns of Retinal Damage and Visual Long-Term Consequences in Patients With Idiopathic Intracranial Hypertension
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVES: Persistent visual impairment is a feared complication of idiopathic intracranial hypertension (IIH). However, the structural and functional retinal changes beyond papilledema and their visual long-term consequences are less well studied. Therefore, we aimed to map patterns of structural and functional retinal damage according to papilledema severity to explain when and by what mechanisms patients with IIH lose vision. METHODS: A prospective cohort study was conducted at 2 tertiary headache centers in Denmark from January 2018 to September 2022. Patients with suspected IIH were consecutively included. Eligibility criteria included clinical suspicion of IIH, age 18 years or older, and written informed consent. The standardized longitudinal diagnostic workup included a structured interview, neurologic and ophthalmologic investigation, lumbar puncture, magnetic resonance imaging, venography, routine blood samples, and diagnostic classification. The primary end point was mechanisms of retinal damage resulting in visual field and acuity impairment according to papilledema severity. A visual outcome score was designed using the desirability of outcome ranking approach. RESULTS: = 0.02), but not with lumbar puncture opening pressure, neurofilament light chain, or IIH-associated magnetic resonance imaging characteristics. DISCUSSION: Our findings suggest 2 different mechanisms of structural and functional retinal impairment depending on papilledema severity. A visual outcome score was proposed, and papilledema severity and disorganization of the inner retinal layer were identified as major predictors of persistent functional retinal impairment.
Source: Neurology
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4415675964