Ophthalmologic prognosis in benign intracranial hypertension

In a prospective study twenty patients with benign intracranial hypertension, 15 females and five males with mean age 34 years (range 12-61 years), were followed up from 12 to 61 months (mean 22 months). Initially all patients showed marked papilledema, normal visual acuity, considerable enlargement of the blind spot area, and significantly delayed pattern reversal visual evoked potentials. During medical treatment eleven patients showed within 3-6 months a rapidly regression and normalization of papilledema, blind spot area, and visual evoked potentials. Eight patients continued in showing papilledema including disc gliosis, enlargement of blind spot area, and pathological visual evoked potentials. One patient developed optic nerve atrophy. The results indicated that repeated examinations of visual evoked potentials, when suspect of threatening visual loss has come up (papilledema, increased blind spot area, and field defects), might increase the change of diagnose of an optic nerve atrophy as early as possible.