Idiopathic intracranial hypertension: Are there predictors for visual outcome or recurrences?
Idiopathic intracranial hypertension: Are there predictors for visual outcome or recurrences?
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DOI：
10.1016/j.clineuro.2019.105378
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发表时间：
2019-08-01
影响因子：
1.9
通讯作者：
Celebisoy, Nese
中科院分区：
文献类型：
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作者：
Tata, Gulten;Kisabay, Aysin;Celebisoy, Nese
目的：目的探讨特发性颅内高压（IIH）患者术后视力预后及复发的预测因素。性别、发病年龄（AODO）、体重指数（BMI）、腰椎穿刺开口压（LP-OP）、logMAR视力（VA）、光盘外观（ODA）、视野（VF）平均偏差（MD）、治疗结果和复发率。平均发病年龄为32.4岁，BMI为311 kg/m2，中位LP-OP为380 mm H2O。所有患者均接受乙酰唑胺治疗，中位剂量为1500 mg。平均随访时间为44.8个月。AODO、BMI、LP-OP与首次或末次访视时的任何检查参数（VA、ODA、VF）均不相关。第一次和最后一次访视时VA和VF之间的相关性不是很强。末次访视的VA与首次访视的VA具有较好的相关性。然而，末次和首次访视VF之间的相关性非常好。治疗后VA和VF均有显著改善，23%复发。复发和非复发患者的人口统计学和临床特征在AODO、BMI、LP-OP、VA、VF或ODA方面无显著差异。结论：IIH患者对乙酰唑胺治疗有反应。首次访视VF是最终视力结果的主要决定因素。复发不能通过人口统计学或临床特征来预测。
Objective: To find out the predictors of final visual outcome and recurrences in idiopathic intracranial hypertension (IIH).Patients and methods: Medical records of 75 patients with IIH were analyzed retrospectively. Gender, age of disease onset (AODO), body mass index (BMI), lumbar puncture opening pressure (LP-OP), visual acuity (VA) in logMAR, optical disc appearance (ODA), visual field (VF) mean deviation (MD), treatment results and recurrence rates were considered.Results: Mean age at onset age was 32.4 years, BMI was 311 kg/m(2) and median LP-OP was 380 mm H2O.All patients were treated with acetazolamide with a median dose of 1500 mg. The mean follow-up period was 44.8 months. AODO, BMI, LP-OP were not correlated with any of the examination parameters (VA, ODA, VF) at the first or last visit. The correlation between the VA and VF both at the first and last visit was not very powerful. VA of the last visit was fairly correlated with the VA of the first visit. However, the correlation between the last and first visit VF was very good. A very significant improvement in both VA and VF was recorded after treatment.Recurrences were noted in 23%. Demographic and clinical features of the recurring and non-recurring patients were not significantly different in terms of AODO, BMI, LP-OP, VA, VF or ODA.Conclusions: The patients with IIH respond to treatment with acetazolamide. First visit VF is the main determinant of the final visual outcome. Recurrences cannot be predicted by the demographic or clinical features at presentation.