Predictors of poor visual outcome in patients with Idiopathic Intracranial Hypertension (IIH): An ambispective cohort study

- In patients of IIH, diminution of vision at presentation is the sole predictor of poor visual outcome at six months.
- MRI brain may of diagnostic but not of prognostic value in IIH.
- Female sex and obesity are less prevalent in patients of IIH in North India.
- History of any visual deficit in patients of IIH warrants aggressive management.

ObjectiveIdiopathic intracranial hypertension (IIH) is a disease of young with threat to vision if not diagnosed timely. This study looked at the putative predictors of poor visual outcome in patients with IIH at six months after presentation via a cohort study.Patients and methodsAll patients diagnosed with IIH from January 2011 to May 2015 were enrolled. The study design was ambispective cohort study. The baseline clinical and radiological characteristics assessed were age, sex, body mass index (BMI), duration of symptoms, transient visual obscuration, cranial nerve palsy, diminution of vision, Cerebrospinal fluid (CSF) opening pressure, empty sella, optic nerve dilatation, global configuration and transverse sinus stenosis. Follow up of visual outcome at six months was done to know the predictors of poor visual outcome.ResultsEighty nine (89) patients were enrolled and 56 patients had follow-up of six months at the time of analysis. Majority of the patients were females (73/89 (82%)). The mean age was 29.9 ± 11.0 years. Mean body mass index (BMI) was 27.1 ± 5.4 kg/m2. Diminution of vision at presentation was seen in 54 (62%) patients. 64 eyes (36%) had visual acuity less than 6/18. Poor visual outcome at six months was seen in 23(41%) patients. Diminution of vision at presentation was found to be a poor predictor.ConclusionWe found female sex and obesity to be less prevalent in our setting. Diminution of vision at presentation was a predictor of poor visual outcome at six months.