Related Experiment Video
Updated: Oct 27, 2025
Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents
Published on: February 15, 2022
Visual outcomes in idiopathic intracranial hypertension in children
Hannah H Chiu1, Y Arun Reginald2, Mahendra Moharir3
1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.
Insights
Idiopathic intracranial hypertension (IIH) in children generally has favorable long-term visual outcomes. Most pediatric patients experienced mild visual impairment, with severe outcomes being rare.
Area of Science:
- Pediatric Ophthalmology
- Neurology
- Clinical Research
Background:
- Idiopathic intracranial hypertension (IIH) is a rare but serious condition in children.
- Understanding the clinical characteristics and visual prognosis of pediatric IIH is crucial for effective management.
- Previous studies have often focused on adult populations, leaving a gap in knowledge regarding long-term outcomes in pediatric cases.
Purpose of the Study:
- To characterize the clinical presentation of pediatric idiopathic intracranial hypertension (IIH).
- To evaluate the long-term visual outcomes in a cohort of children diagnosed with IIH.
- To identify risk factors associated with poor visual prognosis in pediatric IIH.
Main Methods:
- Retrospective observational cohort study design.
- Inclusion of consecutive pediatric patients diagnosed with definite IIH between 2009 and 2020.
- Review of patient charts to analyze clinical features, demographics, and long-term visual impairment data.
Main Results:
- A cohort of 110 children with IIH was analyzed.
- Younger children were less likely to present with headaches and more likely to be asymptomatic.
- Adolescents showed a higher prevalence of female sex and elevated BMI compared to younger children.
- Only 9% of patients with available data experienced mild visual impairment; no severe visual impairment was recorded.
- Increased severity of papilledema at diagnosis was the sole predictor of poor visual outcome.
Conclusions:
- Pediatric idiopathic intracranial hypertension (IIH) is associated with generally favorable long-term visual outcomes.
- Mild visual impairment occurred in less than 10% of the studied pediatric population.
- Early identification and management of papilledema severity are critical for preserving vision in children with IIH.
Objective:
The purpose of this study was to report the clinical characteristics and long-term visual outcomes in a cohort of children with idiopathic intracranial hypertension (IIH).
Design:
Retrospective, observational cohort study.
Participants:
Consecutive children who met the diagnostic criteria for definite IIH at a tertiary care pediatric hospital between 2009 and 2020.
Methods:
The charts of pediatric patients with IIH were reviewed. The main outcome measure was long-term visual impairment, with an analysis of clinical features by age and risk factors for a poor visual outcome.
Results:
There were 110 children (75 females) with IIH. At presentation, younger children with IIH were less likely to present with headaches (p = 0.01) and more likely to be asymptomatic (p = 0.03). There was a strong association with female sex (p < 0.001) and higher body mass index (p < 0.001) in adolescents in comparison to younger children. Of the 90 patients with long-term visual outcome data, only 8 (9%) had evidence of mild visual impairment (1 loss of visual acuity, 7 loss of visual field) with no cases of severe visual impairment. On risk factor analysis, the only variable associated with a poor visual outcome was greater severity of papilledema at diagnosis.
Conclusions:
In this large series of pediatric IIH, the long-term visual outcomes were favourable, with evidence of mild visual impairment in less than 10% of patients.
Related Concept Videos
01:25Glaucoma: Overview
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:28Angle Closure Glaucoma: Treatment