Pseudotumor Cerebri

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Citations: Paley, G. L., Sheldon, C. A., Burrows, E. K., Chilutti, M. R., Liu, G. T., & McCormack, S. E. (2015). Original article: Overweight and Obesity in Pediatric Secondary Pseudotumor Cerebri Syndrome. American Journal Of Ophthalmology, 159344-352.e1. doi:10.1016/j.ajo.2014.11.003 Clara L., A., Aley, T., & Mário Luiz Ribeiro, M. (2015). Factors affecting visual loss and visual recovery in patients with pseudotumor cerebri syndrome / Fatores que influenciam na perda e na recuperação visual de pacientes com a síndrome do pseudotumor cerebral. Arquivos Brasileiros De Oftalmologia, (3), 175. doi:10.5935/0004-2749.20150045

Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)

More Information

2 Types

Secondary

Caused by medications or other preexisting conditions (Paley et al., 2015)

Primary

Idiopathic, occurs without a known cause. Currently thought to be associated with obese/overweight females. (Paley et al., 2015)

Concerns with Disease

Possible retinal hemorrhages (Clara & Ribiero, 2015)

Possible visual field loss due to papilledema (Clara & Ribiero, 2015)

Causes an increased pressure on the optic nerve resulting in permanent damage (Clara & Ribiero, 2015)

Epidemiological Data: Correlational Study by Clara and Ribiero (2015)

Results

Associated with vision loss-->86%

Associated with headaches-->80%

Associated with obesity or being overweight-->increased BMI of 32 kg/cm^2 (class I obesity)

Associated with females-->6:1 ratio (F:M)

Study Parameters

Best Corrected VA

Time from Original Diagnosis

Visual Symptoms

History of Hypertension

Body Mass Index (BMI)

Weight

Sex

50 Subjects (43 F, 7 M)

Differential Diagnosis: Must be a form of Pseudotumor Cerebri

Increased ICP without neurological findings

Major indication of PTC (Clara & Ribiero, 2015)

Possibility of some visual field loss

Patient was unable to obtain a distance VA better than 20/40 suggesting that there must be ocular disease present and possibly some visual field loss (Clara & Ribiero, 2015)

No clear indication of cause-->idiopathic

Correlational studies such as from Clara and Ribiero (2015) suggest that the cause of pseudotumor cerebri is correlated with females, obesity, hypertension, and increased BMI (Clara & Ribiero, 2015)

Not glaucoma

IOP's are within normal range (Clara & Ribiero, 2015)

Patient MRN: 111716

Lumbar Puncture

Increased Intracranial Pressure (ICP)

Findings

Vitreous Opacities

Possible Posterior Vitreous Detachment (PVD)

IOP

OS: 16 mmHg

OD: 15 mmHg

Visual Acuity

Near Aided with Spectacles

OU: 20/20

OS: 20/25

OD: 20/30

Far Aides with Spectacles and Pinhole

OS: 20/40

OD: 20/40+2

Far Aided with Spectacles

OU: 20/40+2

OS: 20/70-1

OD: 20/60-1

Family History

Mother

Hypertension

Father

Diabetes

Laser Eye Surgery for "Hole in Eye" ~20 years ago

Medications and Supplements

Iron

Vitamin D

Ferrous Fumarate (324 mg Tablet)

Valsartan (160mg Tablet)

Bisoprolol Fumarate (10mg)

Albuterol

Previous Diagnoses

Asthma

Presbyopia

Hypertension (150/95)

Sleep Apnea

Papilledema

Pseudotumor Cerebri

Chief Complaint: Flashes and Floaters

African American

49 years old

Female