Association between visual parameters and neuroimaging features of idiopathic intracranial hypertension

Leena V. Padhye, Gregory P. Van Stavern, Aseem Sharma, Ryan Viets, Julie B. Huecker, Mae O. Gordon

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Background/aims Papilledema refers to optic disc swelling resulting from high intracranial pressure (ICP). The precise mechanism by which papilledema occurs remains uncertain. Although orbital neuroimaging features associated with papilledema are well-described, it is unclear whether these findings correlate with visual function. Idiopathic Intracranial Hypertension (IIH) is a condition in which the intracranial pressure is elevated with no obvious cause, causing papilledema and visual loss. The utility of papilledema and IIH neuroimaging findings as a surrogate marker for visual loss, or a predictor of visual loss, is understudied. This retrospective cross-sectional review aims to correlate parameters of visual function with orbital magnetic resonance imaging (MRI) findings. Methods Patients meeting criteria for IIH who had received orbital imaging within 4 weeks of examination were included. Visual parameters of papilledema grade, visual field mean deviation, and visual acuity were correlated with neuroimaging features, including optic nerve thickness, and optic nerve sheath thickness, among others. All MRI scans were reviewed by a neuroradiologist blinded to clinical status. Spearman rank correlations and t-tests were generated with SAS (v9.2). Results Thirty five patients were included. No significant relationships were found between the main visual parameters of papilledema grade and visual field mean deviation, and MRI findings. Conclusions We found no significant correlation between visual parameters and imaging features of papilledema. This might indicate that MRI features may provide insight into the structural changes that occur in papilledema, but may not be helpful when making clinical management decisions for patients with IIH in particular, and papilledema in general.

Original languageEnglish
Pages (from-to)80-85
Number of pages6
JournalJournal of the Neurological Sciences
Volume332
Issue number1-2
DOIs
StatePublished - Sep 15 2013

Keywords

  • Idiopathic intracranial hypertension
  • Neuroimaging
  • Optic neuropathy
  • Orbital imaging
  • Papilledema
  • Pseudotumor cerebri

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