[Evaluation of papilledema and visual improvement in patients with idiopathic intracranial hypertension after venous sinus stenting]. 2021

W Wang, and Q Jia, and Y M Fan, and X D Li, and S B Wang, and L Cheng, and H G Wang, and W L Liang, and L Z Bian, and X G Tong
Graduate School of Tianjin Medical University,Tianjin 300070,China.

Objective: To evaluate the improvement of papilledema and visual acuities in patients with idiopathic intracranial hypertension (IIH) after venous sinus stenting. Methods: The clinical data of 8 IIH patients who met the inclusion criteria underwent venous sinus stenting between January 2013 and December 2016 at Department of Neurosurgery, Tianjin Huanhu Hospital were analyzed retrospectively. There were 6 females and 3 males,aged (32.9±14.4)years (range:19 to 57 years).The thickness of the retinal nerve fiber layer (RNFL) was measured by optical coherence tomography. Fundus,visual acuity and visual field examination were performed before and after operation. If pressure gradient ≥10 mmHg(1 mmHg=0.133 kPa) across the venous stenosis was indicated by intraoperative pressure measurement,the patient would be treated with venous sinus stenting. Intracranial pressure was measured by lumbar puncture 3 to 7 days after operation. RNFL thickness and eye examination were detected 6 months after surgery. CT venogram was used to observe the sinus venous conditions. Paired t test was used to compare the data before and after surgery. Results: All the 8 patients underwent venous sinus stenting successfully. The mean pressure gradient across the venous stenosis was reduced from (24±9.2) mmHg to (2.6±2.0) mmHg (t=8.02,P<0.01). Intracranial pressure decreased from preoperative (41.4±12.7) cmH2O(1 cmH2O=0.098 kPa) to postoperative (12.9±3.3) cmH2O (t=7.08, P<0.01). The RNFL thickness decreased from (275.3±68.3)μm to (131.4±31.8)μm(t=5.80,P<0.05) 6 months after surgery and the baseline visual acuity was improved from(M(Q))0.24 (0.25) to 0.65 (0.23)(Z=-2.52,P<0.05).Papilledema was significantly improved in 6 patients,and no significant change in 2 patients. CT venogram indicated adjacent stent restenosis in 1 patient. Conclusion: Venous sinus stenting can effectively improve papilledema and visual acuity caused by IIH.

UI MeSH Term Description Entries
D008297 Male Males
D010211 Papilledema Swelling of the OPTIC DISK, usually in association with increased intracranial pressure, characterized by hyperemia, blurring of the disk margins, microhemorrhages, blind spot enlargement, and engorgement of retinal veins. Chronic papilledema may cause OPTIC ATROPHY and visual loss. (Miller et al., Clinical Neuro-Ophthalmology, 4th ed, p175) Choked Disk,Edema of the Optic Disc,Edema of the Optic Disk,Optic Disc Edema,Optic Disk Edema,Optic Papilla Edema,Papillitis, Optic,Decreased Intraocular Pressure-Associated Papilledema,Increased Intracranial Pressure-Associated Papilledema,Optic Nerve Papillitis,Papilledema Associated with Decreased Intraocular Pressure,Papilledema Associated with Increased Intracranial Pressure,Papillitis,Retinal Edema,Choked Disks,Decreased Intraocular Pressure Associated Papilledema,Disk, Choked,Edema, Optic Disc,Edema, Optic Disk,Edema, Optic Papilla,Edema, Retinal,Edemas, Optic Disc,Edemas, Optic Disk,Edemas, Retinal,Increased Intracranial Pressure Associated Papilledema,Optic Papillitis,Papillitis, Optic Nerve,Retinal Edemas
D011559 Pseudotumor Cerebri A condition marked by raised intracranial pressure and characterized clinically by HEADACHES; NAUSEA; PAPILLEDEMA, peripheral constriction of the visual fields, transient visual obscurations, and pulsatile TINNITUS. OBESITY is frequently associated with this condition, which primarily affects women between 20 and 44 years of age. Chronic PAPILLEDEMA may lead to optic nerve injury (see OPTIC NERVE DISEASES) and visual loss (see BLINDNESS). Benign Intracranial Hypertension,Idiopathic Intracranial Hypertension,Intracranial Hypertension, Benign,Intracranial Hypertension, Idiopathic,Hypertension, Benign Intracranial,Hypertension, Idiopathic Intracranial
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D015607 Stents Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting. Stent
D041623 Tomography, Optical Coherence An imaging method using LASERS that is used for mapping subsurface structure. When a reflective site in the sample is at the same optical path length (coherence) as the reference mirror, the detector observes interference fringes. OCT Tomography,Optical Coherence Tomography,Coherence Tomography, Optical,Tomography, OCT

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