Visual Field Defects in Pediatric Intracranial Hypertension
David L. Rogers, MD; Hilliary E. Inger, MD; Catherine O. Jordan, MD; Rachel E. Reem, MD; Shawn C. Aylward, MD Nicholas M. Scoville, MD; Amanda L. Way, MD
Nationwide Children’s Hospital
Introduction: Pediatric intracranial hypertension (IH) is of great interest to ophthalmologists due to its potential visual pathology. We sought to describe visual field defects (VFD) in a cohort with pediatric IH.
Methods: A retrospective review of IH patients seen between 1/2010-9/2015 was performed. All patients with an initial VFD were identified, and the defect was described. VFDs that persisted with treatment were identified, or alternatively, the time to resolution was noted.
Results: 111 IH patients were identified, 79 with primary and 32 with secondary etiologies. There were 39 males and 72 females, and age ranged from 7-18 years. 38 patients were identified with visual field deficits, 10 had monocular deficits, and 28 had deficits bilaterally. The most common defect was enlargement of the physiologic blind spot (EBS). EBS was identified in 57 (26%) eyes, either alone (45 eyes) or in combination with other VFDs (12 eyes). 18 (8%) eyes had peripheral VFDs. The most frequent location for any peripheral defect was superior (15 eyes). Three patients had a cecocentral VFD. The median time to resolution of VFDs was 144 days. 8 eyes of 8 patients had a persistent VFD.
Discussion: Resolution of VFDs occurred in a majority of the patients in our study, though a small percentage of VFDs were persistent, irrespective of underlying cause or treatment.
Conclusion: A large proportion of VFDs in pediatric IH patients resolve with appropriate treatment, although the duration of the VFD can be variable.
References: Gospe SM 3rd, Bhatti MT, El-Dairi MA. Anatomic and visual function outcomes in paediatric idiopathic intracranial hypertension. Br J Ophthalmol. 2016 Apr;100(4):505-9.
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