Undiagnosed Papilledema in a Morbidly Obese Patient Population

• DOI: 10.1097/wno.0b013e3182269910
• Publication Date: 2011-07-28T09:32:06Z
• Authors: Claudia M. Krispel; John L. Keltner; William Smith; David G. Chu; Mohamed R. Ali
• Keywords: Papilledema; Fundus (uterus); Pseudotumor cerebri

Background Idiopathic intracranial hypertension (IIH) is a rare condition that can lead to significant morbidity from visual loss. The cause of IIH unknown, but known be associated with obesity. Obese patients may at particularly high risk for suffering vision loss IIH. purpose the present study determine prevalence undiagnosed or asymptomatic papilledema in population morbidly obese individuals and if these should undergo routine screening papilledema. Methods Patients presenting UC Davis Bariatric Surgery Clinic between February 2008 January 2011 who met National Institutes Health criteria bariatric surgery were invited participate study. Those inclusion consented included. Participants screened by nonmydriatic fundus photographs concerning symptoms prompting direct referral neuro-ophthalmologic evaluation. Images reviewed neuro-ophthalmologist, suspicious optic discs underwent findings consistent sent neurological Results A total 606 an average body mass index 47 kg/m2 included Seventeen had photographic disc Seven did not have edema on clinical examination. Six evaluated clinic. Four 17 subtle confirmed evaluation referred full workup. These 4 normal neuroimaging, 3 whom lumbar punctures borderline opening pressures. All unremarkable field examinations. Fundus abnormalities other than discovered 33 patients. Conclusion Our suggests patient population, rare. Routine photography likely warranted.