Archivos de la Sociedad Espanola de Oftalmologia · 2006
[Utility of optic coherence tomography (OCT) in the follow-up of idiopathic intracranial hypertension in childhood].
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Sánchez-Tocino H, Bringas R, Iglesias D, González-Pérez A, Del Villar-Galán R
Аннотация
PURPOSE: To show the utility of optic coherence tomography (OCT) in the follow up of the idiopathic intracranial hypertension (IIH) in childhood.
METHODS: Three girls, aged between 4 and 11 years, were diagnosed and subsequently followed with the help of OCT for an episode of idiopathic intracranial hypertension. All of them had presented with non-specific symptoms such as visual disturbance, headache, stomach ache, and in one case diplopia and torticolis. Brain imaging studies were normal, however lumbar puncture found an elevated intracranial pressure. Visual fields were tested using Octopus automated perimetry and the optic nerve fiber layer (ONF) was measured by OCT at each of the attendances.
RESULTS: The visual acuity was normal in all cases, but two girls had evidence of an abducens nerve palsy. Fundus biomicroscopy revealed marked papilledema. The thickness of the ONF was increased 2-3 times over normally expected levels. The follow up and the treatment with prednisone and azetazolamide was monitored by OCT, with a good outcome and return of the ONF levels to normal. In one case, however, a recurrence was detected after three months without treatment.
CONCLUSION: IIH in childhood is an uncommon condition, often with a different presentation from what is seen in teenagers and adults. OCT is a useful technique helping in both the diagnosis and the follow-up of this disorder in children (Arch Soc Esp Oftalmol 2006; 81: 383-390).
METHODS: Three girls, aged between 4 and 11 years, were diagnosed and subsequently followed with the help of OCT for an episode of idiopathic intracranial hypertension. All of them had presented with non-specific symptoms such as visual disturbance, headache, stomach ache, and in one case diplopia and torticolis. Brain imaging studies were normal, however lumbar puncture found an elevated intracranial pressure. Visual fields were tested using Octopus automated perimetry and the optic nerve fiber layer (ONF) was measured by OCT at each of the attendances.
RESULTS: The visual acuity was normal in all cases, but two girls had evidence of an abducens nerve palsy. Fundus biomicroscopy revealed marked papilledema. The thickness of the ONF was increased 2-3 times over normally expected levels. The follow up and the treatment with prednisone and azetazolamide was monitored by OCT, with a good outcome and return of the ONF levels to normal. In one case, however, a recurrence was detected after three months without treatment.
CONCLUSION: IIH in childhood is an uncommon condition, often with a different presentation from what is seen in teenagers and adults. OCT is a useful technique helping in both the diagnosis and the follow-up of this disorder in children (Arch Soc Esp Oftalmol 2006; 81: 383-390).