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Journal of Pediatric Gastroenterology... Nov 2020Ophthalmic abnormalities are amongst the 5 major criteria required for a diagnosis of Alagille syndrome (ALGS), of which embryotoxon, pseudopapilledema, and...
AIMS AND BACKGROUND
Ophthalmic abnormalities are amongst the 5 major criteria required for a diagnosis of Alagille syndrome (ALGS), of which embryotoxon, pseudopapilledema, and hypopigmented retinopathy are the most common. Papilledema with or without intracranial hypertension (ICHT) is rarely described. We report 9 pediatric cases of ALGS with bilateral papilledema, 5 of which were diagnosed with ICHT.
METHODS
The ophthalmic data from 85 patients with clinically and/or genetically (n = 37) proven ALGS were reviewed. The study inclusion criteria were a positive diagnosis of ALGS and availability of ophthalmic follow-up data. Ophthalmic data from 40 patients after liver transplantation (LT) for other indications were also analyzed.
RESULTS
Nine (13.0%) of the 69 patients meeting the inclusion criteria had papilledema. The neurological and neuroimaging results in all 9 patients were normal. These 9 patients were categorized into 4 groups: a nontransplant group (n = 1), a group with pretransplant papilledema persistent after LT (n = 2), a group with papilledema occurring after LT with spontaneous resolution (n = 1), and a group with papilledema and signs of ICHT after LT (n = 5). The patients with ICHT were treated with steroids alone (n = 1) or with acetazolamide (n = 4). A ventriculoperitoneal shunt was placed in 2 of the 5 cases because of progressive visual loss. Pseudopapilledema was present in 10 additional patients (14.5%, 10/69). One (2.5%) of the 40 patients without ALGS developed papilledema after LT.
CONCLUSIONS
True ICHT may be underdiagnosed in patients with ALGS. Our findings underscore the need for close ophthalmic follow-up before and after LT in these patients.
Topics: Alagille Syndrome; Child; Eye Diseases, Hereditary; Humans; Intracranial Hypertension; Optic Nerve Diseases; Papilledema
PubMed: 33093373
DOI: 10.1097/MPG.0000000000002883 -
The Pan African Medical Journal 2023papilledema refers to the swelling of the head of the optic nerve, a major sign of many local, locoregional or systemic pathologies that may involve patients' visual or...
INTRODUCTION
papilledema refers to the swelling of the head of the optic nerve, a major sign of many local, locoregional or systemic pathologies that may involve patients' visual or vital prognosis. This condition represents a diagnostic and therapeutic emergency frequently encountered in our facilities. Therefore, it is deemed and opportune to identify the most common etiologies observed in Cameroonian hospitals.
METHOD
we conducted a documentary and descriptive study of patients with papilledema presenting to the Ophthalmology Department of the Hospital of Instruction, Application and Reference of the Armed Forces of Yaoundé from 1 October 2013 to 31 December 2016. The variables under investigation included epidemiological data (age, sex), clinical data (functional signs, visual acuity, appearance of the papilla and associated signs according to the Hoyt and Beesten classification), complementary examinations performed (fluorescein angiography, visual field, biology, radiography, CT scan) and the etiological diagnosis. Epi-info 3.5.3 software was used for statistical analysis and the Chi-square test was performed at a 5% significance level (p < 5%).
RESULTS
during the study period, papilledema was found in 26 out of 5023 patients, reflecting a rate of 0.5%. The average age of patients was 32.7± 10.9 years, ranging from 7 to 79 years, for 13 women and 13 men. Papilledema was bilateral in 15 (57.7%) patients and unilateral in 11 (42.3%), or 41 affected eyes. The etiologies were 11 (42,3%) inflammatory optic neuropathies, 5 (19,2%) arterial hypertension, 4 (15,4%) central retinal vein occlusions, 3 (11,5%) eye contusions, 2 (7,7%) hydrocephalus and 1 case (3,9%) of cerebral malaria.
CONCLUSION
inflammatory and vascular optic neuropathies were the most common etiologies of papilledema in our facilities.
Topics: Male; Humans; Female; Young Adult; Adult; Papilledema; Cameroon; Hospitals; Optic Nerve Diseases; Eye
PubMed: 37637400
DOI: 10.11604/pamj.2023.45.66.36676 -
JAMA Network Open Jun 2020The study of health conditions associated with papilledema will augment the clinical judgment of eye care professionals treating patients with optic disc edema in...
IMPORTANCE
The study of health conditions associated with papilledema will augment the clinical judgment of eye care professionals treating patients with optic disc edema in determining the urgency of additional evaluation and counseling patients accordingly.
OBJECTIVES
To determine the incidence, demographic characteristics, and etiologies of papilledema based on a unique records-linkage research platform; and to describe the demographic and clinical differences between patients with idiopathic intracranial hypertension (IIH) and other causes of papilledema.
DESIGN, SETTING, AND PARTICIPANTS
Retrospective population-based cross-sectional study of patients treated for papilledema at outpatient eye clinics in Olmsted County, Minnesota, using the Rochester Epidemiology Project. Data were collected from January 1990 to December 2014 and analyzed from September 2018 to April 2019.
MAIN OUTCOMES AND MEASURES
Etiologies of papilledema, body mass index, incidence of headache, or localizing neurologic signs.
RESULTS
Eighty-six patients were diagnosed with papilledema during the 24-year period, providing an age- and sex-adjusted incidence of 2.5 individuals per 100 000 per year; 68 patients (79%) were women, 73 (85%) were white patients, and the median (range) age was 27.7 (6.2-64.2) years. Nineteen patients (22%) presented with a previously diagnosed attributable cause (eg, trauma or intracranial tumor). Among patients presenting with papilledema without a previously diagnosed attributable cause, 58 patients (87%) had IIH, and 9 patients (13%) were found to have a secondary cause of raised intracranial pressure, such as intracranial tumor, cerebral venous sinus thrombosis, or granulomatous meningitis. Patients with IIH had a higher median (range) body mass index (37.5 [20.4-55.7] vs 27.4 [16.6-40.1]; P = .003) and headache prevalence (54 of 58 patients [93%] vs 6 of 9 patients [67%]; P = .004) than patients with other causes of papilledema. Of 9 patients with papilledema but no IIH, 2 (22%) had localizing neurologic signs, such as gait abnormalities, hearing loss, focal weakness or numbness, visual field defects, or aphasia. Among 42 patients with demographic characteristics typically associated with IIH (female sex, with obesity, aged 15 to 45 years, and absent localizing neurologic signs or symptoms), 40 (95%) had papilledema that was associated with IIH. Conversely, among the 19 patients without these demographic characteristics, 7 (37%) had an alternative cause.
CONCLUSIONS AND RELEVANCE
In this study, most patients who presented to the eye clinic with papilledema without a previously known cause were found to have IIH. These patients were more likely to present with headaches and had statistically higher body mass index. Clinicians should take these findings into account when determining the pretest probability of a patient having IIH or an alternative cause of papilledema.
Topics: Adolescent; Adult; Body Mass Index; Brain Neoplasms; Cerebral Veins; Child; Cross-Sectional Studies; Female; Headache; Humans; Incidence; Male; Middle Aged; Minnesota; Papilledema; Pseudotumor Cerebri; Retrospective Studies; Sinus Thrombosis, Intracranial; Young Adult
PubMed: 32484553
DOI: 10.1001/jamanetworkopen.2020.6625 -
British Medical Journal Mar 1978
Topics: Humans; Papilledema
PubMed: 630232
DOI: 10.1136/bmj.1.6112.578 -
British Medical Journal Mar 1978
Topics: Humans; Neural Inhibition; Papilledema; Vision Disorders
PubMed: 630349
DOI: 10.1136/bmj.1.6115.784-a -
Tidsskrift For Den Norske Laegeforening... Jun 2019
Topics: Aged; Female; Fluorescein Angiography; Humans; Magnetic Resonance Imaging; Meningeal Neoplasms; Meningioma; Optic Nerve Diseases; Papilledema
PubMed: 31238653
DOI: 10.4045/tidsskr.18.0719 -
Clinical & Experimental Optometry Nov 2016Oligodendrogliomas are rare slow-growing asymptomatic glial tumours that usually present in patients in their fourth to sixth decades of life. Neurological symptoms that... (Review)
Review
Oligodendrogliomas are rare slow-growing asymptomatic glial tumours that usually present in patients in their fourth to sixth decades of life. Neurological symptoms that may present include nausea, headache, vomiting, diplopia, confusion, focal weakness, numbness and seizures. The treatment of oligodendroglioma tumours is based on functional status classification, lumbar puncture, imaging of the head, tumour biopsy and genetic testing. Grades II and IV oligodendroglial tumours, which have co-deletion of the short arm of chromosome 1 (1p) and the long arm of chromosome 19 (19q) and mutations in isocitrate dehydrogenase, have the most favourable prognosis, as they respond well to neurosurgery and chemotherapy. This report will discuss a general case of papilloedema in a young patient with oligodendroglioma and the role of the optometrist in its post-neurosurgical and chemotherapeutic care.
Topics: Adult; Brain Neoplasms; Humans; Magnetic Resonance Imaging; Male; Oligodendroglioma; Papilledema; Tomography, Optical Coherence; Visual Fields
PubMed: 27489047
DOI: 10.1111/cxo.12416 -
Romanian Journal of Ophthalmology 2020We present the case of a 12-year-old boy with bilateral papilledema, relating moderate symptomatology and without an important medical history. Ophthalmological...
We present the case of a 12-year-old boy with bilateral papilledema, relating moderate symptomatology and without an important medical history. Ophthalmological examination revealed a significant alteration of visual acuity, an important papilledema and macular edema in both eyes. Further investigations excluded infectious and autoimmune diseases, intracranial masses and congenital affliction. Because of an elevated opening pressure in lumbar puncture procedure, the diagnosis of intracranial hypertension was confirmed. After two weeks of treatment with corticosteroids, carbonic anhydrase inhibitor and hyperosmotic drug, the patient had an important structural and functional ophthalmological improvement.
Topics: Carbonic Anhydrase Inhibitors; Child; Humans; Male; Optic Disk; Papilledema; Pseudotumor Cerebri; Tomography, Optical Coherence; Visual Acuity
PubMed: 33367182
DOI: 10.22336/rjo.2020.66 -
Canadian Journal of Ophthalmology.... Dec 2019The purpose of this retrospective study was to identify the types and relative frequencies of intracranial disorders in pediatric patients who present with papilledema.
OBJECTIVE
The purpose of this retrospective study was to identify the types and relative frequencies of intracranial disorders in pediatric patients who present with papilledema.
DESIGN
Retrospective case series.
PARTICIPANTS AND METHODS
This study was conducted in 2 pediatric ophthalmology clinics, both providing community-based care in a large inner-city urban center in the U.S. Pediatric patients aged between 0 and 16 years diagnosed with papilledema and who had an underlying etiology identified were included in the study. Patient demographic data, ophthalmologic examination findings, and diagnostic work-up results were identified from clinical records.
RESULTS
The mean age of 38 study patients (19 female, 19 male) was 8.6 ± 4.8 years. Of the 38 patients, 16 (42.1%) had idiopathic intracranial hypertension (IIH) as the underlying cause of the papilledema, 7 (18.4%) had a craniosynostosis disorder, 6 (15.8%) had intracranial tumours, 2 (5.3%) had primary hydrocephalus, and 1 (2.6%) patient each had transverse sinus thrombosis related to sinusitis, hypertensive crisis, subdural hematoma, intracranial abscess, Lyme disease, presumed neurosarcoidosis, and acute disseminated encephalomyelitis. Of the 6 intracranial tumours, 2 (33.3%) presented in the sellar/parasellar region, 2 (33.3%) in the posterior fossa, and 2 (33.3%) were in cortical locations.
CONCLUSION
Clinicians should have a high index of suspicion for IIH and brain tumours in children presenting with papilledema. Patients with craniosynostosis should have routine eye examinations to monitor for asymptomatic papilledema. Understanding the relative incidence of etiologies for papilledema highlights the urgency of appropriate work-up and the need to consider low-frequency etiologies.
Topics: Adolescent; Brain Diseases; Brain Neoplasms; Child; Child, Preschool; Craniosynostoses; Female; Humans; Hydrocephalus; Infant; Infant, Newborn; Male; Papilledema; Pseudotumor Cerebri; Retrospective Studies
PubMed: 31836094
DOI: 10.1016/j.jcjo.2019.02.007 -
Current Opinion in Ophthalmology Nov 2010Obstructive sleep apnea is a diagnosis that ophthalmologists can screen for when a patient presents with certain risk factors. Recent literature provides strong data for... (Review)
Review
PURPOSE OF REVIEW
Obstructive sleep apnea is a diagnosis that ophthalmologists can screen for when a patient presents with certain risk factors. Recent literature provides strong data for associations between sleep apnea and ocular disorders.
RECENT FINDINGS
A potentially serious disorder, sleep apnea can lead to many systemic and ocular complications. Recent findings provide data on the prevalence of sleep apnea with various disorders. Adequate treatment of sleep apnea has also shown to reverse both systemic and eye-related complications.
SUMMARY
Early diagnosis and management of sleep apnea is critical for reducing the risk of devastating systemic complications and preserving ocular and visual function. Further longitudinal data are needed to see the effectivity of long-term management of sleep apnea and its impact on reversing associated complications.
Topics: Central Serous Chorioretinopathy; Eyelid Diseases; Humans; Optic Nerve Diseases; Papilledema; Sleep Apnea, Obstructive
PubMed: 20811281
DOI: 10.1097/ICU.0b013e32833f00dc