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Papilledema
Neuro-Ophthalmology
Key Points
- •Papilledema = bilateral disc edema from raised ICP ONLY - unilateral disc edema should never be called papilledema
- •Always image before lumbar puncture - CT/MRI must be done first to exclude a mass lesion and prevent fatal transtentorial herniation
- •The IIHTT (JAMA 2014) demonstrated acetazolamide (up to 4 g/day) + weight loss improves visual field by 0.71 dB more than diet alone (treatment effect; p=0.050) and papilledema grade - established evidence-based medical therapy for IIH
- •Transient visual obscurations (TVOs) lasting seconds, triggered by postural changes - hallmark symptom of papilledema, not seen in optic neuritis
- •Inferonasal quadrant is the first visual field sector to be lost in chronic papilledema - progressive constriction eventually leads to blindness if untreated
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations