Background: Idiopathic Intracranial Hypertension (IIH),
previously known as pseudotumor cerebri, is characterised by elevated
intracranial pressure without an identifiable secondary cause and predominantly
affects overweight women of reproductive age. Visual morbidity due to
papilledema and secondary optic atrophy remains the most feared complication.
Objective: To comprehensively review and synthesise current
evidence on ocular structural, vascular, and functional changes associated with
IIH, with emphasis on modern imaging biomarkers and their role in diagnosis and
disease monitoring.
Methods: A narrative review of published literature was
performed, focusing on clinical ophthalmic findings, optical coherence
tomography (OCT), OCT-angiography (OCT-A), and orbital neuroimaging features in
IIH.
Results: IIH primarily affects the optic nerve head and
posterior segment, with minimal anterior segment involvement. Peripapillary
retinal nerve fibre layer thickening, ganglion cell complex loss, retinal
vascular remodelling, and characteristic MRI features such as optic nerve
sheath distension and posterior globe flattening are consistently reported. OCT
and OCT-A provide quantitative, reproducible biomarkers that correlate with
intracranial pressure and visual function.
Conclusion: Ocular imaging plays a pivotal role in the
diagnosis, monitoring, and prognostication of IIH. Early detection and
longitudinal OCT-based surveillance are essential for preventing irreversible
vision loss.
Author(s) Details
Ruchi Shukla
Department of Ophthalmology, All India Institute of Medical Sciences,
Raebareli, Uttar Pradesh, India.
Aparajita Shukla
Department of Ophthalmology, All India Institute of Medical Sciences,
Raebareli, Uttar Pradesh, India.
Ashutosh Kumar Mishra
Department of Neurology, All India Institute of Medical Sciences,
Raebareli, Uttar Pradesh, India.
Please see the book here :- https://doi.org/10.9734/bpi/msup/v5/6996
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