Micronutrient Deficiencies Presenting with Optic Disc Swelling Associated with or without Intracranial Hypertension:...

Area of Science:

• Neurology
• Ophthalmology
• Nutritional Science

Background:

• Idiopathic intracranial hypertension (IIH) is a neurological disorder causing optic disc swelling due to increased intracranial pressure (ICP) of unknown origin.
• Obesity is a primary risk factor for IIH, and associated nutrient-poor diets may contribute to the condition.
• Current diagnostic criteria for IIH do not typically include micronutrient deficiencies, except for iron deficiency.

Purpose of the Study:

• To identify micronutrient deficiencies, excluding iron, that can mimic IIH symptoms like optic disc swelling.
• To evaluate if these deficiencies could meet diagnostic criteria for IIH.
• To inform diagnostic and treatment protocols for IIH and related conditions.

Main Methods:

• A systematic literature search was performed for articles published between January 1, 1980, and December 18, 2020.
• The search focused on case reports and series detailing optic disc swelling associated with micronutrient deficiencies.
• Sixty-five eligible cases were identified, all being case reports or series with a high risk of bias.

Main Results:

• The review identified potential links between optic disc swelling and deficiencies in vitamin A, vitamin B1, and vitamin B12.
• These deficiencies may present with symptoms overlapping with IIH diagnostic criteria.
• The identified studies were primarily case reports and series, indicating a high risk of bias.

Conclusions:

• Patients diagnosed with IIH or presenting with unexplained optic disc swelling should be screened for vitamin A, B1, and B12 deficiencies.
• Nutritional support and improved dietary quality should be integrated into weight management strategies for IIH patients.
• Further research is needed to establish causal links and refine diagnostic guidelines regarding micronutrient deficiencies in IIH.