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The optic disc is minimal in children with idiopathic intracranial hypertension

Shuan Dai1, Carmelina Trimboli, J Raymond Buncic

  • 11Department of Ophthalmology, Greenlane Clinical Center, Auckland, New Zealand.

Journal of Child Neurology
|October 5, 2012
PubMed

Insights

Children with idiopathic intracranial hypertension often lack a physiological optic disc cup. This finding in optic nerve head morphology may indicate a predisposition to developing intracranial hypertension.

Area of Science:

  • Ophthalmology
  • Neurology
  • Pediatrics

Background:

  • Idiopathic intracranial hypertension (IIH) is a condition causing elevated intracranial pressure without a clear cause.
  • Optic disc morphology, including the cup-to-disc ratio, is crucial in assessing optic nerve health.
  • Understanding optic disc variations in pediatric IIH can offer insights into disease mechanisms.

Purpose of the Study:

  • To characterize optic disc morphology in children diagnosed with idiopathic intracranial hypertension.
  • To compare optic disc parameters, specifically the cup-to-disc ratio, in pediatric IIH patients to established norms.
  • To investigate the prevalence of absent physiological optic cups in this cohort.

Main Methods:

  • Retrospective review of medical charts and digital optic disc photographs of pediatric IIH patients.
  • Digital measurement of optic disc area, cup area, and cup-to-disc ratio using VISUPAC software.
  • Comparison of measured parameters against published normative data for age-matched children.

Main Results:

  • A high prevalence (83%) of absent physiological optic disc cups was observed in children with IIH.
  • The median optic disc area was 2.2 mm², and the median cup area was 0.0 mm² in the IIH cohort.
  • These findings contrast significantly with published norms (median disc area 2.69 mm², median cup area 0.44 mm²).

Conclusions:

  • Children with idiopathic intracranial hypertension exhibit a significantly high prevalence of small or absent optic disc cups.
  • The frequent absence of a physiological cup in pediatric IIH suggests a potential underlying predisposition.
  • This optic nerve head characteristic may be a contributing factor or indicator in the development of intracranial hypertension.

Keywords:
idiopathic increased intracranial pressureoptic disc sizepseudotumor cerebri

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