Irini Chatziralli1, Panagiotis Theodossiadis2, George Theodossiadis2, Ioannis Asproudis3. 1. 2nd Department of Ophthalmology, Attikon Hospital, University of Athens, 1 Rimini street, Haidari, 12462, Athens, Greece. eirchat@yahoo.gr. 2. 2nd Department of Ophthalmology, Attikon Hospital, University of Athens, 1 Rimini street, Haidari, 12462, Athens, Greece. 3. Department of Ophthalmology, University of Ioannina, Ioannina, Greece.
Abstract
PURPOSE: The purpose of this review is to shed light into the diagnostic challenges regarding idiopathic intracranial hypertension (IIH), giving more emphasis to the role of optical coherence tomography (OCT) in IIH, while it also presents recent advances in the management of IIH. METHODS: A literature search in PubMed was performed for studies about the diagnosis and management of IIH published before June 30, 2017. Then, a comprehensive review of the eligible studies and the relevant references was performed. RESULTS: Apart from the updated modified criteria, OCT has been found to be important for the diagnosis of IIH, along with assessment of clinical signs and symptoms, brain imaging, and lumbar puncture. On the other hand, there is no current consensus for the management of IIH, but various interventions have been used, such as dietary therapy (weight loss, bariatric surgery, lifestyle modification, low-salt diet), medications, and surgical treatment. CONCLUSIONS: IIH is a challenging and serious disorder, which may lead to permanent visual impairment if there is a delay in its diagnosis. Advances in retinal imaging have led to better understanding of the pathogenesis of the disease and prompt diagnosis even in subtle cases can be done using OCT. Surgical interventions should be minimized and only used in cases refractory to medical treatment and in those with rapid progression.
PURPOSE: The purpose of this review is to shed light into the diagnostic challenges regarding idiopathic intracranial hypertension (IIH), giving more emphasis to the role of optical coherence tomography (OCT) in IIH, while it also presents recent advances in the management of IIH. METHODS: A literature search in PubMed was performed for studies about the diagnosis and management of IIH published before June 30, 2017. Then, a comprehensive review of the eligible studies and the relevant references was performed. RESULTS: Apart from the updated modified criteria, OCT has been found to be important for the diagnosis of IIH, along with assessment of clinical signs and symptoms, brain imaging, and lumbar puncture. On the other hand, there is no current consensus for the management of IIH, but various interventions have been used, such as dietary therapy (weight loss, bariatric surgery, lifestyle modification, low-salt diet), medications, and surgical treatment. CONCLUSIONS: IIH is a challenging and serious disorder, which may lead to permanent visual impairment if there is a delay in its diagnosis. Advances in retinal imaging have led to better understanding of the pathogenesis of the disease and prompt diagnosis even in subtle cases can be done using OCT. Surgical interventions should be minimized and only used in cases refractory to medical treatment and in those with rapid progression.
Authors: Michael Wall; Michael P McDermott; Karl D Kieburtz; James J Corbett; Steven E Feldon; Deborah I Friedman; David M Katz; John L Keltner; Eleanor B Schron; Mark J Kupersmith Journal: JAMA Date: 2014 Apr 23-30 Impact factor: 56.272
Authors: Alexandra J Sinclair; Michael A Burdon; Peter G Nightingale; Alexandra K Ball; Peter Good; Timothy D Matthews; Andrew Jacks; Mark Lawden; Carl E Clarke; Paul M Stewart; Elizabeth A Walker; Jeremy W Tomlinson; Saaeha Rauz Journal: BMJ Date: 2010-07-07