Paediatric Idiopathic Intracranial Hypertension: Presenting Features, Management, and Visual Outcomes in a Single Centre Cohort.

Purpose Idiopathic Intracranial Hypertension (IIH) is an important cause of papilloedema in children that can lead to visual loss. This study examined patient demographics combined with presenting signs and symptoms in paediatric patients with IIH. We also investigated the visual outcomes of these patients over the course of their treatment. Methods This retrospective study examines the presenting features and visual outcomes of children with IIH attending a tertiary multi-disciplinary-focused (paediatric neurology and neuro-ophthalmology) centre. Results 70% of our study population was female, and 60% of all children were overweight, although there was a significant difference in BMI ranges in younger (<10 years) and older children. Headache and papilloedema were the predominant presenting features in the study. Following treatment, most (96%) had visual acuity of better than 6/9 in both eyes. Visual field testing revealed half had enlargement of the blind spot on Humphrey visual field testing as expected with papilloedema. Most defects recovered with treatment, although residual visual field defects persisted in others. Our cases were treated successfully with medical therapy, and only one patient required acute surgical intervention with VP shunting on presentation. Conclusions With the increasing prevalence of obesity in the UK, the incidence of paediatric IIH may potentially increase. Our cohort had a favourable outcome following treatment, which emphasizes the importance of early diagnosis and management of this condition to prevent visual morbidity. We recommend a multidisciplinary approach to managing IIH patients to allow a comprehensive assessment of their visual function in response to treatment.