Abstract
Purpose To describe the significance of macular changes to visual outcome in benign intracranial hypertension (BIH).
Method The clinical and photographic records of 24 patients with BIH who required optic nerve sheath fenestration were analysed.
Results Macular changes were found in 21 of 48 (44%) eyes. These were: choroidal folds 9; circumferential lines (Paton's lines) 4; nerve fibre layer haemorrhage 3; macular stars 5; macular oedema 6; retinal pigment epithelial changes 4; subretinal haemorrhage leading to a macular scar 1. Significant visual loss attributable to the macular changes was found in 5 eyes in the short term and 3 in the long term. The 2 eyes that improved had macular stars. Of the 3 eyes that did not improve, 2 eyes had retinal pigment epithelial changes and 1 a large subretinal haemorrhage that led to a macular scar. These 3 cases had long-standing BIH.
Conclusions The majority of macular changes resolve and do not add to visual loss from optic nerve damage. Patients with marked macular oedema are at most risk of permanent visual loss and should be considered for early treatment such as optic nerve sheath fenestration.
Similar content being viewed by others
Article PDF
References
Gittinger JW, Asdourian GK . Macular abnormalities in papilledema from pseudotumor cerebri. Ophthalmology 1989;96:192–4.
Morris AT, Sanders MD . Macular changes resulting from papilloedema. Br J Ophthalmol 1980;64:211–6.
Keane JR . Papilledema with unusual ocular hemorrhages. Arch Ophthalmol 1981;99:262–3.
Bird AC, Sanders MD . Choroidal folds in association with papilloedema. Br J Ophthalmol 1973;57:89–97.
Corbett JJ, Jacobson DM, Mauer RC, Thompson HS . Enlargement of the blind spot caused by papilledema. Am J Ophthalmol 1988;105:261–5.
Corbett JJ, Savino PJ, Thompson HS, et al. Visual loss in pseudotumor cerebri: follow-up of 57 patients from five to 41 years and a profile of 14 patients with permanent severe visual loss. Arch Neurol 1982;39:461–74.
Baker RS, Bunic JR . Sudden visual loss in pseudotumor cerebri due to central retinal artery occlusion. Arch Neurol 1984;41:1274–6.
Spoor TC, Ramochi JM, Madia MP . Treatment of pseudotumour cerebri by primary and secondary optic nerve sheath decompression. Am J Ophthalmol 1991;112:177–85.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Talks, S., Mossa, F. & Elston, J. The contribution of macular changes to visual loss in benign intracranial hypertension. Eye 12, 806–808 (1998). https://doi.org/10.1038/eye.1998.208
Issue Date:
DOI: https://doi.org/10.1038/eye.1998.208
Keywords
This article is cited by
-
Bilateral idopathic optic nerve sheath meningocele associated with unilateral transient cystoid macular oedema
Eye (2002)
-
New developments in idiopathic intracranial hypertension
Current Neurology and Neuroscience Reports (2001)