Original articlePuberty as a Risk Factor for Less Favorable Visual Outcome in Idiopathic Intracranial Hypertension
Section snippets
Methods
We included all 102 patients with the diagnosis of IIH who presented to the Neuro-Ophthalmology Unit at Rabin Medical Center between January 2001 and June 2003. The study was presented to the institutional review board (IRB). IRB approval was not needed as no intervention was applied, nor was follow-up of patients any different than that of all IIH patients.
Inclusion criteria were normal brain magnetic resonance imaging (MRI) and magnetic resonance venography (MRV), or computed tomographic
Results
Data of final visual outcome was available for 96 of 102 patients with IIH. Follow-up range was 12 months (minimum) to 2.5 years, mean 20 months. The age distribution of final visual outcomes is detailed in Table 1. Excellent visual outcome was recorded in 11 (42%) of 26 patients of pubertal age, in seveb four (58%) of seven prepubertal children, four (67%) of six teenagers, and 50 (88%) of 57 adults. Table 2 reports the frequency distribution of puberty as an age group, anemia, obesity,
Discussion
While a relatively small number of respondents in the younger age group posed some difficulties in analysis, converging results for the series of analyses reveals a novel observation that less favorable visual outcome in IIH is associated with a critical period around puberty. It further suggests a nonlinear relationship between outcome and age, which may explain why other studies have not found such a relationship. Cinciripini, Donahue, and Borchert2 have already demonstrated that prepubertal
Hadas Stiebel-Kalish, MD, is the chief of the Neuro-ophthalmology division at Rabin Medical Center, Israel. Dr Stiebel-Kalish is engaged in clinical service and in research focused on endovascular neuro-ophthalmology, increased intracranial hypertension, neurosarcoidosis, and the measurement of ACE activity in the cerebrospinal fluid and in gene expression of pituitary adenomas.
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Hadas Stiebel-Kalish, MD, is the chief of the Neuro-ophthalmology division at Rabin Medical Center, Israel. Dr Stiebel-Kalish is engaged in clinical service and in research focused on endovascular neuro-ophthalmology, increased intracranial hypertension, neurosarcoidosis, and the measurement of ACE activity in the cerebrospinal fluid and in gene expression of pituitary adenomas.