title: Perimetry, retinal nerve fiber layer thickness and papilledema grade after cerebrospinal fluid shunting in patients with idiopathic intracranial hypertension.
abstract: BACKGROUND
  To investigate the effect of cerebrospinal fluid (CSF) shunting on quantitative perimetry and papilledema in patients with uncontrolled idiopathic intracranial hypertension (IIH).
  
  
  METHODS
  We retrospectively reviewed all cases of IIH with CSF shunting at our institution between 2004 and 2011. Perimetry was performed before and after surgery in 15 patients, and the mean deviation (MD) was compared before and after surgery to assess the effect of the intervention.
  
  
  RESULTS
  Fourteen of the IIH patients were female and 1 was male. The average age was 34 years. CSF shunting resulted in significant improvement in the perimetric results with an increase in the MD of 5.63 ± 1.19 dB (P < 0.0001). Additionally, average retinal nerve fiber layer (RNFL) thickness measurement by optical coherence tomography decreased by 87.27 ± 16.65 μm (P < 0.0001), and Frisen papilledema grade decreased by 2.19 ± 0.71 (P < 0.0001).
  
  
  CONCLUSIONS
  Our results suggest that CSF shunting results in improvement in perimetry, RNFL swelling, and papilledema grade in patients with IIH.
authors.affiliation: Department of Ophthalmology and Vision Science (JLR, KVL, JLK), University of California Davis Eye Center, Sacramento, California; Departments of Neurology and Ophthalmology and Visual Sciences (MW), University of Iowa, Iowa City, Iowa; Department of Public Health, Clinical and Translational Science Center (MDW), University of California Davis, Davis, California; and Departments of Neurology and Neurological Surgery (JLK), University of California Davis, Sacramento, California.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Rizzo
authors.forename: Khoa V
authors.initials: KV
authors.lastname: Lam
authors.forename: Michael
authors.initials: M
authors.lastname: Wall
authors.forename: Machelle D
authors.initials: MD
authors.lastname: Wilson
authors.forename: John L
authors.initials: JL
authors.lastname: Keltner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D010211:Papilledema / Q000209:etiology / Q000601:surgery*; D011559:Pseudotumor Cerebri / Q000150:complications / Q000601:surgery*; D012160:Retina / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000601:surgery*; D058609:Visual Field Tests / Q000379:methods; D055815:Young Adult