Visual outcomes in idiopathic intracranial hypertension in children.

Abstract

OBJECTIVE\nThe purpose of this study was to report the clinical characteristics and long-term visual outcomes in a cohort of children with idiopathic intracranial hypertension (IIH).\n\n\nDESIGN\nRetrospective, observational cohort study.\n\n\nPARTICIPANTS\nConsecutive children who met the diagnostic criteria for definite IIH at a tertiary care pediatric hospital between 2009 and 2020.\n\n\nMETHODS\nThe charts of pediatric patients with IIH were reviewed. The main outcome measure was long-term visual impairment, with an analysis of clinical features by age and risk factors for a poor visual outcome.\n\n\nRESULTS\nThere were 110 children (75 females) with IIH. At presentation, younger children with IIH were less likely to present with headaches (p\u2009=\u20090.01) and more likely to be asymptomatic (p\u2009=\u20090.03). There was a strong association with female sex (p\u2009<\u20090.001) and higher body mass index (p\u2009<\u20090.001) in adolescents in comparison to younger children. Of the 90 patients with long-term visual outcome data, only 8 (9%) had evidence of mild visual impairment (1 loss of visual acuity, 7 loss of visual field) with no cases of severe visual impairment. On risk factor analysis, the only variable associated with a poor visual outcome was greater severity of papilledema at diagnosis.\n\n\nCONCLUSIONS\nIn this large series of pediatric IIH, the long-term visual outcomes were favourable, with evidence of mild visual impairment in less than 10% of patients.