Peripapillary Choroidal Neovascular Membrane (P-CNVM) in Idiopathic Intracranial Hypertension (IIH): Clinical Profile and Outcomes at a Neuro-Ophthalmic Care Centre.

To report the clinical profile and outcomes of Peripapillary choroidal neovascular membrane (p-CNVM) in patients with idiopathic intracranial hypertension (IIH): at a neuro-ophthalmic care centre. We retrospectively studied records of IIH patients who developed pCNVM seen at our institute from January 1, 2016 to January 1, 2023. Data was collected regarding demographics, body mass index (BMI), Cerebrospinal fluid (CSF) opening pressure, fundus photographs, fluorescein angiography FFA, indocyanine green angiography (ICGA), optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A), treatment given and outcomes. 7 patients (9 eyes, all women, median age: 30.5 years) met the study criteria. Median BMI was 34.2 kg/m2. Median CSF opening pressure was 33.0 cm H2O. Median time from papilledema diagnosis to CNVM formation was 6.5 (IQR: 4.5-12.25) months. All patients were treated with intravitreal anti-VEGF and acetazolamide. Best corrected Visual acuity (logMAR) worsened in the right eye slightly from, 0.50 (IQR: 0.15-0.90) logMAR at presentation to 0.90 (IQR: 0.57-1.00) LogMAR at final visit. The left eye showed minimal improvement in BCVA from 0.65 (IQR: 0.28-0.95) to 0.37 (IQR: 0.18-0.85) logMAR. One patient underwent shunt surgery, while another needed optic nerve sheath fenestration for IIH. CNVM either resolved completely or was resolving in all patients, while papilledema showed resolution in all patients except one. Peripapillary Type 2 CNVM is an infrequent but significant complication of IIH, Multimodal imaging-including OCT, FFA and ICGA helps in diagnosis and monitoring. We recommend continued that acetazolamide treatment along with concurrent anti-VEGF treatment helps in managing both IIH and pCNVM.