[Idiopathic Intracranial Hypertension: Clinical-Epidemiological Profile and Factors Associated with Visual Outcome].

Abstract

The prevalence of idiopathic intracranial hypertension (IIH) has been increasing along with the incidence of obesity in the population. There is little national statistical data on this pathology.

Aim: To characterize cases of IIH clinically and epidemiologically and analyze factors associated with visual outcomes.

Methods: Retrospective study. Review of clinical records of patients with IIH treated in a Chilean public hospital between 2010-2021. Statistical analysis of clinical, treatment, and visual outcome variables.

Results: 140 patients were included and 90.7% were women. The average age was 32 years and 92% were overweight/obese. The main presenting symptom was headache, followed by transient visual obscurations and diplopia. Visual acuity was normal in two-thirds, and 10.4% had severe visual impairment. Papilledema was present in 96.5%. In the visual field, the most frequent defect was an 85% increase in the blind spot. Treatment with acetazolamide was effective in 76.8% of cases, requiring high doses and prolonged use. Surgery was necessary in 24% of patients, with the installation of a lumboperitoneal shunt being the most common. In factors associated with visual outcome, greater papilledema and lack of response to medical treatment showed a statistically significant association with visual deterioration.

Conclusions: Our study provides national data and confirms the classic profile of patients with IIH. Factors associated with visual impairment are the presence of severe papilledema and lack of response to medical treatment. Studies are required to determine the response to surgical treatment.