The Retinal Layers in the Preservation of Visual Acuity in the Early Stages of Idiopathic Intracranial Hypertension

Purpose: To investigate the thickness of the retinal layers in the preservation of visual acuity in the early stages of the disease in patients with papilledema associated with idiopathic intracranial hypertension (IIH).

Study Design: Retrospective clinical study.

Methods: Right eyes of 23 IIH patients and 28 healthy control subjects were included in the study. Peripapillary retinal nerve fiber layer (RNFL) thickness in four quadrants and average ganglion cell layer (GCL) thickness measured by high-definition optical coherence tomography (at a presentation in both groups, and also at 6-months after the presentation in the patient group) were retrospectively analysed.

Results: Mean age was 38.9±11.9 years in the patients and 42.8±10.2 years in the control subjects (p=0.19). All of the participants were female. Mean RNFL in all quadrants was significantly higher in the patients compared to controls. Mean RNFL in all quadrants was considerably lower at 6-months of presentation compared to that at presentation (p<0.005), whereas mean GCL was similar in both groups.

Conclusion: No changes were observed in the GCL of IIH patients in the early stage, despite significant RNFL changes. This may explain the preservation of visual acuity in the early stages of the disease.