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Weight reduction for a better visual outcome in idiopathic intracranial hypertension.

AbstractPURPOSE:
To evaluate the correlation between weight reduction and visual outcome in overweight patients with idiopathic intracranial hypertension.
METHODS:
Thirty-nine newly diagnosed, overweight (body mass index >25 kg/m2) patients with idiopathic intracranial hypertension were studied retrospectively. All patients underwent medical treatment with acetazolamide, and a weight reduction program was also offered. Patients were grouped according to their compliance with this weight reduction program into the diet-success (Group 1) and diet-failure groups (Group 2). Body mass index, papilledema, visual acuity, and perimetric mean deviation were compared at the end of the 6-month study period.
RESULTS:
Groups 1 and 2 did not differ regarding the baseline mean body mass index (32.63 ± 5.61, 32.35 ± 5.06 kg/m2), visual acuity (0.080 ± 0.13, 0.130 ± 0.24 logMAR), perimetric mean deviation (-9.978 ± 0.68, -12.86 ± 8.91), or papilledema grade (2.94 ± 0.22, 2.90 ± 0.30), respectively (p>0.05). During the 6 months' follow-up, Group 1 patients, who complied with both medical and diet therapy, improved significantly in all parameters, including body mass index (p<0.001), visual acuity (p=0.001), perimetric mean deviation (p=0.016), and papilledema grade (p<0.001). Conversely, Group 2 patients, who only underwent medical therapy, improved only in papilledema grade (p<0.001). However, coincident development of optic disc pallor was observed in three patients. Further, they also had significant loss in visual acuity (p=0.047) during the study period.
CONCLUSION:
Weight reduction combined with medical treatment is associated with significantly better improvement in visual acuity, visual field, and papilledema in idiopathic intracranial hypertension patients. Compliance with an efficient diet program should be encouraged in overweight patients with idiopathic intracranial hypertension.
AuthorsFeray Koc, Mehmet Resit Isik, Nazife Sefi-Yurdakul
JournalArquivos brasileiros de oftalmologia (Arq Bras Oftalmol) 2018 Jan-Feb Vol. 81 Issue 1 Pg. 18-23 ISSN: 1678-2925 [Electronic] Brazil
PMID29538589 (Publication Type: Journal Article)
Topics
  • Adult
  • Body Mass Index
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Overweight (complications, physiopathology)
  • Papilledema (diet therapy, etiology, physiopathology)
  • Pseudotumor Cerebri (diet therapy, physiopathology)
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Vision Disorders (diet therapy, etiology, physiopathology)
  • Visual Acuity (physiology)
  • Visual Fields (physiology)
  • Weight Loss (physiology)

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