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Paediatric IIH: Are There Differences in Visual Outcomes and Recurrence Rates?
Jenna Rock1, Jacqueline K Shaia2,3, Jeffrey Chu1
1School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Neuro-Ophthalmology (Aeolus Press)
|September 22, 2025
Summary
Paediatric idiopathic intracranial hypertension (IIH) in children shows distinct prepubertal and post-pubertal features. However, visual outcomes and papilledema recurrence rates are similar across these groups.
Area of Science:
- Pediatric Neurology
- Ophthalmology
Background:
- Idiopathic intracranial hypertension (IIH) is rare in children, with distinct prepubertal and post-pubertal presentations.
- Significant knowledge gaps exist regarding treatment, visual outcomes, and recurrence rates between these pediatric IIH populations.
Purpose of the Study:
- To compare prepubertal and post-pubertal pediatric IIH.
- To analyze demographic differences, treatment variations, visual outcomes, and papilledema recurrence risk.
Main Methods:
- Retrospective chart review of pediatric patients (0-18 years) diagnosed with IIH or papilledema between June 2012 and September 2023.
- Patients stratified by pubertal status (prepubertal vs. post-pubertal) and met revised Dandy criteria; secondary causes excluded.
- Data collected on demographics, treatment, and visual outcomes at baseline and 1-year follow-up; recurrence incidence analyzed.
Main Results:
- Of 128 pediatric IIH patients, 62% were post-pubertal and 38% prepubertal.
- Post-pubertal patients had higher rates of overweight/obesity and were more frequently female (p < .05).
- Poor visual outcomes (4.7%) and papilledema recurrence (24%) did not significantly differ between pubertal groups (p > .05).
Conclusions:
- While demographic and presenting features of pediatric IIH differ between prepubertal and post-pubertal children, visual outcomes and recurrence rates are comparable.
- Further research may explore underlying mechanisms for these observed demographic differences.
