title: Association between visual parameters and neuroimaging features of idiopathic intracranial hypertension.
abstract: OBJECTIVE
  Papilledema refers to optic disc swelling resulting from high intracranial pressure (ICP). The precise mechanism by which papilledema occurs remains uncertain. Although orbital neuroimaging features associated with papilledema are well-described, it is unclear whether these findings correlate with visual function. Idiopathic Intracranial Hypertension (IIH) is a condition in which the intracranial pressure is elevated with no obvious cause, causing papilledema and visual loss. The utility of papilledema and IIH neuroimaging findings as a surrogate marker for visual loss, or a predictor of visual loss, is understudied. This retrospective cross-sectional review aims to correlate parameters of visual function with orbital magnetic resonance imaging (MRI) findings.
  
  
  METHODS
  Patients meeting criteria for IIH who had received orbital imaging within 4 weeks of examination were included. Visual parameters of papilledema grade, visual field mean deviation, and visual acuity were correlated with neuroimaging features, including optic nerve thickness, and optic nerve sheath thickness, among others. All MRI scans were reviewed by a neuroradiologist blinded to clinical status. Spearman rank correlations and t-tests were generated with SAS (v9.2).
  
  
  RESULTS
  Thirty five patients were included. No significant relationships were found between the main visual parameters of papilledema grade and visual field mean deviation, and MRI findings.
  
  
  CONCLUSIONS
  We found no significant correlation between visual parameters and imaging features of papilledema. This might indicate that MRI features may provide insight into the structural changes that occur in papilledema, but may not be helpful when making clinical management decisions for patients with IIH in particular, and papilledema in general.
authors.affiliation: School of Medicine, Washington University in St. Louis, MO 63108, United States.
authors.forename: Leena V
authors.initials: LV
authors.lastname: Padhye
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Van Stavern
authors.forename: Aseem
authors.initials: A
authors.lastname: Sharma
authors.forename: Ryan
authors.initials: R
authors.lastname: Viets
authors.forename: Julie B
authors.initials: JB
authors.lastname: Huecker
authors.forename: Mae O
authors.initials: MO
authors.lastname: Gordon
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve; D017063:Outcome Assessment, Health Care; D010211:Papilledema / Q000209:etiology*; D011559:Pseudotumor Cerebri / Q000134:cerebrospinal fluid / Q000150:complications*; D012189:Retrospective Studies; D014786:Vision Disorders / Q000134:cerebrospinal fluid / Q000209:etiology*; D014794:Visual Fields / Q000502:physiology; D055815:Young Adult
keywords: Idiopathic intracranial hypertension; Neuroimaging; Optic neuropathy; Orbital imaging; Papilledema; Pseudotumor cerebri