-
The British Journal of Ophthalmology Sep 1972
Topics: Adult; Diagnosis, Differential; Female; Fluorescein Angiography; Fundus Oculi; Humans; Male; Middle Aged; Ophthalmoscopy; Papilledema; Phlebitis; Prednisolone; Retinal Vein; Visual Acuity
PubMed: 4653856
DOI: 10.1136/bjo.56.9.652 -
Indian Journal of Ophthalmology Jun 2021The aim of this study was to investigate the role of inflammation in the pathogenesis of idiopathic intracranial hypertension (IIH) using the neutrophil-to-lymphocyte...
PURPOSE
The aim of this study was to investigate the role of inflammation in the pathogenesis of idiopathic intracranial hypertension (IIH) using the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as inflammation markers.
METHODS
The files of 33 IIH patients and 33 controls were screened for this retrospective study. For each patient, the NLR and PLR values were calculated using a single fasting blood sample. For both eyes, papilledema (PE) grades, best-corrected visual acuity (BCVA), retinal nerve fiber layer thickness (RNFLT), and ganglion cell layer thickness (GCLT) measurements were recorded along with the demographic data, including body mass index (BMI), and complete neurological and ophthalmological findings. Comparisons between the two groups and between the IIH patients with and without PE were made. The associations of NLR and PLR with all other parameters were analyzed independently from age, gender, and BMI.
RESULTS
NLR and PLR were higher in patients with IIH than controls (P < 0.05). They were also higher in patients with PE (P < 0.05) in the IIH group. NLR and PLR were found to be associated with BCVA (P < 0.001 and P = 0.023, respectively), global RNFLT (P = 0.004 and 0.012, respectively), RNFLT of the temporal quadrant (P < 0.001 and P = 0.042, respectively) and PE grade (P < 0.001 and P = 0.035, respectively).
CONCLUSION
The NLR and PLR values and their associations with BCVA, RNFLT, and PE support the hypothesis that inflammation is a very important component of the pathogenesis of IIH.
Topics: Humans; Inflammation; Lymphocytes; Neutrophils; Papilledema; Pseudotumor Cerebri; Retrospective Studies
PubMed: 34011728
DOI: 10.4103/ijo.IJO_2030_20 -
Neurology India 2022Idiopathic intracranial hypertension (IIH) is well-described entity in literature. However, large studies on clinical and radiological profile are still very few from... (Observational Study)
Observational Study
BACKGROUND
Idiopathic intracranial hypertension (IIH) is well-described entity in literature. However, large studies on clinical and radiological profile are still very few from the Indian subcontinent.
AIMS
To analyze the clinical and radiological profile of IIH and correlation of various clinical and radiological parameters with papilledema and CSF opening pressure.
SETTING AND DESIGN
Hospital-based observational, descriptive study.
MATERIALS AND METHODS
This study analyzed 122 patients admitted in the department of Neurology (from January 2014 to December 2018) for detailed history, clinical examination, and neuroimaging. CSF manometry and routine CSF analysis were done. All participants met the modified Dandy criteria. Patients with secondary causes of raised ICP and primary ocular pathology were excluded.
STATISTICAL ANALYSIS USED
Descriptive statistics and Chi-square test.
RESULTS
Among 122 cases 86 (70.49%) were females. The mean age was 33 years. 62 (50.82%) cases were obese. Headache was the most common symptom (114/122; 93.44%). Bilateral papilledema was noted in 114 (93.44%) cases. Higher grades of papilledema had a correlation with higher CSF opening pressure. Empty sella was the most common radiological finding (100/122; 81.97%). All radiological findings except empty sella had a correlation with higher CSF opening pressure.
CONCLUSION
IIH typically affects obese females of childbearing age group. However, it is not uncommon in the nonobese and male sex. Obesity may not be a dominant risk factor for the development of IIH in the Indian subcontinent. Cases with normal BMI and male sex with clinical features of raised intracranial pressure and normal neuroimaging should also be evaluated for IIH. Cases with refractory headache and empty sella on MRI should be evaluated for IIH.
Topics: Adult; Female; Headache; Humans; India; Intracranial Hypertension; Male; Obesity; Papilledema; Pseudotumor Cerebri; Tertiary Care Centers
PubMed: 35532643
DOI: 10.4103/0028-3886.344644 -
Transactions of the American... 1971
Topics: Adult; Facial Paralysis; Female; Humans; Male; Ophthalmoscopy; Papilledema; Parotitis; Phlebitis; Retinal Diseases; Sarcoidosis; Uveitis
PubMed: 5154266
DOI: No ID Found -
Agri : Agri (Algoloji) Dernegi'nin... Jul 2022In this article, we report a patient with migraine who was hospitalized with a prediagnosis of pseudotumor cerebri and diagnosed as neurobrucellosis with isolated...
In this article, we report a patient with migraine who was hospitalized with a prediagnosis of pseudotumor cerebri and diagnosed as neurobrucellosis with isolated intracranial hypertension presentation. A 22-year-old woman was admitted to emergency department with a complaint of headache. Her anamnesis indicated that she had migraine for 7 years. Neurological examination revealed bilateral papilledema. Cranial magnetic resonance imaging was normal. Cerebrospinal fluid (CSF) examination revealed 80 lymphocytes per mm3 with 178 mg/dL protein. Opening pressure was 260 mmH2O. Brucella tube agglutination and Rose Bengal tests were positive in blood and CSF. She was diagnosed as neurobrucellosis. If the systemic findings are insignificant and neurological findings are atypical such as isolated papillary edema, neurobrucellosis may not be considered and its diagnosis may be delayed. We believe that brucella serology should be included in the diagnostic protocols in endemic areas. Thus, early diagnosis and appropriate treatment can prevent complications of neurobrucellosis.
Topics: Adult; Brucellosis; Female; Humans; Magnetic Resonance Imaging; Migraine Disorders; Papilledema; Pseudotumor Cerebri; Young Adult
PubMed: 35792692
DOI: 10.14744/agri.2020.20053 -
JAMA Ophthalmology Jun 2021While 6-month data are available regarding spaceflight-associated neuro-ocular syndrome, manned missions for 1 year and beyond are planned, warranting evaluation for...
IMPORTANCE
While 6-month data are available regarding spaceflight-associated neuro-ocular syndrome, manned missions for 1 year and beyond are planned, warranting evaluation for spaceflight-associated neuro-ocular syndrome beyond 6 months.
OBJECTIVE
To determine if the manifestation of spaceflight-associated neuro-ocular syndrome worsens during International Space Station missions exceeding the present 4- to 6-month duration.
DESIGN, SETTING, AND PARTICIPANTS
The One-Year Mission Study used quantitative imaging modalities to investigate changes in ocular structure in 2 crew members who completed a 1-year-long spaceflight mission. This study investigated the ocular structure of crew members before, during, and after their mission on the International Space Station. Two crew members participated in this study from March 2015 to September 2016. Analysis began in March 2015 and ended in May 2020.
EXPOSURES
Crew members were tested before, during, and up to 1 year after spaceflight.
MAIN OUTCOMES AND MEASURES
This study compares ocular changes (peripapillary retinal edema, axial length, anterior chamber depth, and refraction) in two 1-year spaceflight mission crew members with cohort crew members from a 6-month mission (n = 11). Minimum rim width (the shortest distance between Bruch membrane opening and the internal limiting membrane) and peripapillary total retinal thickness were measured using optical coherence tomography.
RESULTS
Both crew members were men. Minimum rim width and total retinal thickness increased in both participants throughout the duration of spaceflight exposure to the maximal observed change from preflight (minimum rim width: participant 1, 561 [+149 from preflight] μm at flight day 270; participant 2, 539 [+56 from preflight] μm at flight day 270; total retinal thickness: participant 1, 547 [+135 from preflight] μm at flight day 90; participant 2, 528 [+45 from preflight] μm at flight day 210). Changes in peripapillary choroid engorgement, axial length, and anterior chamber depth appeared similar between the 1-year mission participants and a 6-month mission cohort.
CONCLUSIONS AND RELEVANCE
This report documents the late development of mild optic disc edema in 1 crew member and the progressive development of choroidal folds and optic disc edema in another crew member over the duration of 1 year in low Earth orbit aboard the International Space Station. Previous reports characterized the ocular risk associated with 4 to 6 months of spaceflight. As future spaceflight missions are planned to increase in duration and extend beyond low Earth orbit, further observation of astronaut ocular health on spaceflight missions longer than 6 months in duration may be warranted.
Topics: Astronauts; Choroid; Female; Humans; Male; Optic Disk; Papilledema; Space Flight
PubMed: 33914020
DOI: 10.1001/jamaophthalmol.2021.0931 -
JAMA Network Open Jun 2020
Topics: Diagnosis, Differential; Humans; Optic Nerve; Papilledema
PubMed: 32484550
DOI: 10.1001/jamanetworkopen.2020.7159 -
Survey of Ophthalmology 1993On routine examination, a 61-year-old man was found to have a deep peripapillary hemorrhage surrounding his left optic nerve head. Further examination revealed a left...
On routine examination, a 61-year-old man was found to have a deep peripapillary hemorrhage surrounding his left optic nerve head. Further examination revealed a left sixth nerve paresis, a subtle right homonymous quadrantanopia, and jerky pursuit to the left. The diagnostic work-up was delayed by the patient because of business commitments. He returned confused and obtunded. Neuro-imaging showed a large frontal mass, which turned out to be an anaplastic astrocytoma. Diagnosis of the lesion had been obscured by three false localizing signs. Discussion deals with the definition of Terson's syndrome and the occurrence of peripapillary hemorrhages. Other causes of peripapillary hemorrhages are illustrated.
Topics: Astrocytoma; Brain Neoplasms; Cerebral Cortex; Fluorescein Angiography; Fundus Oculi; Humans; Male; Middle Aged; Optic Disk; Papilledema; Retinal Hemorrhage; Tomography, X-Ray Computed
PubMed: 8484169
DOI: 10.1016/0039-6257(93)90066-g -
Indian Journal of Ophthalmology Apr 2022To determine the correlation between functional parameters and optical coherence tomography (OCT) features in patients of idiopathic intracranial hypertension (IIH). (Observational Study)
Observational Study
PURPOSE
To determine the correlation between functional parameters and optical coherence tomography (OCT) features in patients of idiopathic intracranial hypertension (IIH).
METHODS
A prospective observational study in early and established cases of papilledema in IIH presenting from December 2017 to February 2019. Functional parameters (visual acuity, contrast sensitivity, mean deviation, VER, and MfERG) and structural parameters (RNFL, GCL-IPL, and optic disc height) were measured at baseline and every 6 weeks for 6 months.
RESULTS
At baseline, average RNFL had a moderate negative correlation with mean deviation (r = -0.45; P = 0.0007) and a positive correlation with logMAR visual acuity (r = 0.18; P = 0.17). On the contrary, baseline GCL and logMAR visual acuity had a negative correlation (r = -0.4, P = 0.02). Optic disc height (ODH) had a negative correlation with visual field mean deviation (r = -0.046; P = 0.0005). At 6 months, ODH and GCL-IPL complex had a statistically significant correlation with functional parameters. However, RNFL values did not show any significant correlation with any of the functional parameters. Baseline GCL-IPL and optic disc height values had a moderate and significant correlation with final functional parameters. However, RNFL did not show any correlation with final functional parameters. Correlation between GCL-IPL thickness at 6 weeks and final functional parameters were stronger than that with baseline GCL values.
CONCLUSION
In the setting of severe papilledema, RNFL can misguide the prognosis. GCL-IPL can be a valuable tool for an objective evaluation of the integrity of the optic nerve in IIH and ODH may be used as an alternative or in combination with GCL-IPL in these cases.
Topics: Humans; Nerve Fibers; Papilledema; Pseudotumor Cerebri; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 35326052
DOI: 10.4103/ijo.IJO_2103_21 -
Acta Neurologica Scandinavica Aug 2018Papilloedema is a clinical manifestation of chronically raised intracranial pressure (ICP), often seen in idiopathic intracranial hypertension (IIH). However, the extent...
OBJECTIVES
Papilloedema is a clinical manifestation of chronically raised intracranial pressure (ICP), often seen in idiopathic intracranial hypertension (IIH). However, the extent of intracranial hypertension required to produce papilloedema is not known. We compare ICP values in IIH patients who developed papilloedema and those who did not. We aim to identify a pathological ICP threshold predictive of the development of papilloedema in IIH patients.
MATERIALS AND METHODS
Single-centre cohort of IIH patients (2006-2016) who underwent 24-hour ICP monitoring (ICPM) and ophthalmology assessments, prior to intervention. Papilloedema was graded according to the Frisén scale. An unpaired t-test compared 24-hour ICPM between papilloedema and no-papilloedema groups. Fisher's exact test was used to determine predictive value of ICP.
RESULTS
Thirty-six patients with IIH (35 F: 1M), mean age 32.5 ± 9.49 years (mean ± SD) were included. Patients with papilloedema had a mean median 24-hour ICP of 10.4 ± 5.32 mm Hg (n = 25), significantly higher than the group without papilloedema 6.31 ± 3.30 mm Hg (n = 11) (P < .05). The papilloedema group were exposed to higher pressures (10 mm Hg) for 30 minutes or more. Using 24-hour median ICP of 10 mm Hg as a minimum cut-off predictive value gives a specificity = 91%, sensitivity = 48%, PPV = 92% and NPV = 44% of detecting papilloedema.
CONCLUSIONS
A 24-hour ICP of 10 mmHg or more is a good predictor for papilloedema and reflects a pathological threshold. The range varied widely suggesting papilloedema can occur at even lower pressures. These results are consistent with emerging evidence suggest that pathologically "high" 24 hours ICP is lower than previously quoted.
Topics: Adult; Female; Humans; Male; Neurophysiological Monitoring; Papilledema; Pseudotumor Cerebri; ROC Curve; Reference Values; Retrospective Studies; Young Adult
PubMed: 29532475
DOI: 10.1111/ane.12922