Evidence map›Paper›PMID 39930564›Full record

ArticleJournal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society2025

Longitudinal Visual Outcomes and Risk of Papilledema Recurrence in Fulminant Idiopathic Intracranial Hypertension.

Jacqueline K Shaia, Jenna R Rock, Jeffrey Y Chu, Ilene P Trinh, Taseen A Alam, Rishi P Singh, Katherine E Talcott, Devon A Cohen

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In one paragraph

Article in Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Jacqueline K ShaiaDepartment of Population and Quantitative Health Sciences (JKS), Case Western Reserve University, Cleveland, Ohio; Case Western Reserve School of Medicine (JKS, JRR, JYC, IPT, TAA), Cleveland, Ohio; Center for Ophthalmic Bioinformatics (JKS, RPS, KET), Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Cole Eye Institute (RPS, KET, DAC), Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (RPS, KET, DAC), Cleveland Ohio; and Cleveland Clinic Martin Hospitals (RPS), Cleveland Clinic, Cleveland, Florida.ORCID 0000-0001-7873-669
Jenna R Rock
Jeffrey Y Chu
Ilene P Trinh
Taseen A Alam
Rishi P Singh
Katherine E Talcott
Devon A Cohen

Funding

RESOURCE/SERVICE CORE C - MOLECULAR INFORMATICS MODULEP30EY025585 · NEI · CLEVELAND CLINIC LERNER COM-CWRU · PI BELA ANAND-APTE · 2016 to 2026
$7.7M
Cole Eye Institute Vision Science Training ProgramT32EY024236 · NEI · CLEVELAND CLINIC LERNER COM-CWRU · PI ANAND-APTE, BELA · 2015 to 2025
$1.0M
NEI NIH HHS P30 EY025585NEI NIH HHS T32 EY024236Research to Prevent Blindness P30EY025585(BA-A)
6 · The paper itself

Abstract

backgroundFulminant idiopathic intracranial hypertension (IIH) is a rare presentation of IIH characterized by rapid visual loss. Little is known regarding the cause of fulminant IIH and how to treat this condition. We conducted an analytical study aimed at characterizing disease, treatment, and visual outcomes while evaluating the time and frequency of recurrence of papilledema.

methodsThis retrospective cohort study used records at a single tertiary institution screened between June 1, 2012, and September 31, 2023, for having an international classification of diseases (ICD) code of IIH or papilledema. After meeting the revised Dandy diagnostic criteria and excluding secondary causes of IIH using clinical review, fulminant IIH was determined by rapid visual loss occurring within 1 month of symptom onset. Demographics, treatment, and visual outcomes data were collected with final visual outcomes reported between 3 months and 1 year after diagnosis. Surgical intervention and relapse of papilledema were noted. All analyses were performed in R Studio and Excel, with a P value <0.05 being significant.

resultsOf the 731 IIH patients who were evaluated during this interval, 3.2% had fulminant IIH (n = 24). Patients had a mean age of 27.6 years and presented with an average visual field mean deviation of -19.55 dB. Overall, 95.8% were overweight/obese, 87.5% female, and 50% were Black. In total, 62.5% of patients with fulminant IIH received optic nerve sheath fenestrations. At follow-up, 41.7% of patients were legally blind (with 20/400 vision or worse), including 13% having no light perception. Within our cohort, 42% had a significant visual deficit (visual field mean deviation worse than -7 dB or best-corrected visual acuity between 20/80 and 20/200). Although not statistically significant, patients who underwent cerebral venous sinus stenting had the smallest visual deficit. On average, patients recovered from their initial papilledema after 7.90 months. One quarter (25%) of patients had a recurrence at 4.5 months (SD ± 4.1) after the initial resolution of papilledema.

conclusionsFulminant IIH is a rare and blinding variant of IIH. Owing to the recurrence time after initial papilledema resolution, we recommend all such patients be monitored until 8 months after initial papilledema resolution. Future studies should evaluate optimal surgical interventions for preserving vision.

Indexed as

PapilledemaPseudotumor CerebriVisual AcuityAdolescentAdultFemaleFollow-Up StudiesHumansMaleMiddle AgedRecurrenceRetrospective StudiesRisk FactorsYoung Adult

Identifiers

PMID39930564
PMCPMC12309414

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