ASOPRSFall Scientific SymposiumSyllabus
72
PediatricOculofacial Plastic Surgery
Moderator: EricM. Hink,MD
4:30pm
Trends inPediatric Idiopathic Intracranial Hypertension (IIH):
AMulticenter Studyof TreatmentOutcomes
RebeccaShields
1
, RobertoWarman
2
,Wendy Lee
1
, KaraCavuoto
1
.
1
Ophthalmology, BascomPalmer Eye Institute,Miami, FL,
UnitedStates,
2
Ophthalmology,Miami Children’sHospital,Miami, FL, UnitedStates
Introduction:
Idiopathic intracranial hypertension (IIH) commonly presents in obese females of child-bearing age. Ourmulti-center
study investigates current disease treatment and outcomes in children.
Methods:
A retrospectivemulti-center chart review identified children (4-17 years) diagnosedwith IIH from2002-2012. Gender, age,
bodymass index (BMI), optic nerve head (ONH) edema, treatment and outcomeswere identified.
Results:
Fifty-four patientswere divided into group 1 (4-8 years), group 2 (9-12 years) and group 3 (13-17 years).The average
agewas 11.5 years, differing significantly betweenmales and females (9.7 versus 13.3 years, p=0.001). ONH edemawasmost
severe in group 3 and higher in females (median grade 4).Thirteen children underwent surgical intervention, of which 70%were
female (9/13). In the surgical group, the average grade of ONH edemawas grade 3 (p=0.04) withmedian visual acuity of 20/70
pre-intervention and 20/25 post-intervention.ThemedianONH edema post-intervention in the surgical groupwas grade 1.Medical
treatment, however,was the predominant management method (41/54). In themedical group, the averageONH edemawas grade 2
(p=0.04) withmedian visual acuity of 20/25 pre-intervention and 20/20 post-intervention. ONH edema post-intervention revealed a
median of grade 0.
Conclusions:
Bothmedical and surgical treatment groups demonstrated overall improvement; however, themedical treatment group
demonstrated better outcomes.This is likely due to the severity of ONH edema in the surgical group. Pubescent female patientswere
also found to requiremore invasive treatment methods and haveworse visual prognosis.
References:
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Baryshnik, DB., et al. “Changes in the appearances of venous sinuses after treatment of disordered intracranial pressure.”Neurology
62:1445-6, 2004.
Cinciripini., et al. “Idiopathic Intracranial Hypertension in Prepubertal Pediatric Patients: Characterstics,Treatment, andOutcome.”
American Journal of Ophthalmology. Vol 127 (2): 178-182, 1999.
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Rangwala, Lubiana., et al. “Pediatric Idiopathic Intracranial Hypertension.”Survey of Ophthalmology. 52 (6) 597-617, 2007.
Rowe, FJ. “The relationship between obesity and idiopathic intracranial hypertension.” Int JObes Relat MetabDisord 23:
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DetailedProgram
—Thursday,October 16, 2014
