[Papilledema in children over a 10-year period in a French tertiary center]

To describe the demographic and clinical characteristics of pediatric patients presenting with papilledema in a tertiary university center.

This study is a single-center retrospective study of papilledema in patients under 18 years of age between January 2013 and January 2023. Visual acuity, visual field defects and retinal nerve fiber layer thickness were recorded at the beginning and conclusion of follow-up. The etiological diagnosis was established based on ocular and physical clinical examination, brain imaging and cerebrospinal fluid analysis.

Eighty-five patients (162 eyes) were included. The mean age at diagnosis was 9.0±5.7 years, ranging from 0.1 to 17.9 years, with a mean follow-up of 15.6±19.1 months. The main etiology of papilledema, affecting 63 patients, was secondary intracranial hypertension (74.1%), mostly due to intracranial masses (20%), intracranial hemorrhages/hematomas (16.5%), and cerebral venous thrombosis (9.4%). Twenty-two patients (25.9%) had idiopathic intracranial hypertension. During follow-up, 6 patients (7.1%) died from their condition.

In our tertiary center, the leading cause of papilledema was secondary intracranial hypertension, which differs from results of primary, secondary, or outpatient settings. Our study highlights the need for multidisciplinary approach in diagnosis and management of children with papilledema. These findings might guide clinicians in their evaluation of the underlying etiology.