Abstract：
OBJECTIVE: To evaluate the effect of weight reduction on the structural and functional parameters of the optic nerve in established cases of papilledema in Idiopathic Intracranial Hypertension (IIH).
METHODS: A prospective observational study in early and established cases of papilledema in IIH presenting from December 2019 to February 2021. Functional parameters (visual acuity, contrast sensitivity, mean deviation, VER), structural parameters (RNFL, GCL-IPL, and optic disc height), and clinical grading of papilledema were measured at baseline and every 6 weeks for 6 months. All patients underwent medical (oral acetazolamide) and diet therapy.
RESULTS: Mean body mass index (BMI) at presentation was 26.32 ± 3.52 kg/m² and the mean change in BMI over 6 months was 1.27 ± 0.50 kg/m². 67% of eyes had papilledema of grades 2-3 at the presentation. At the end of 6 months, 75% of eyes had grade 1 papilledema while 13% showed complete resolution. A reduction of 5.32 ± 3.58 in mean deviation (r = 0.316; p-value 0.01) and gain in VER P100 amplitude of 4.2 ± 2.7 µV (r = 0.40; p-value 0.003) were noted over 6 months with reduction in BMI over 6 months. A statistically significant reduction in optic disc height (ODH) was noticed with BMI reduction over 6 months (p = 0.0007; r = 0.45).A reduction of 1.72 ± 0.90 kg/m² (equivalent to 6.53% weight loss) in BMI was associated with a four-grade change in clinical grading of papilledema.
CONCLUSIONS: Reduction in BMI had a significant impact on both structural and functional parameters of the optic nerve in IIH. The involvement of a well-certified dietician should be an integral part of treatment in IIH.
METHODS: A prospective observational study in early and established cases of papilledema in IIH presenting from December 2019 to February 2021. Functional parameters (visual acuity, contrast sensitivity, mean deviation, VER), structural parameters (RNFL, GCL-IPL, and optic disc height), and clinical grading of papilledema were measured at baseline and every 6 weeks for 6 months. All patients underwent medical (oral acetazolamide) and diet therapy.
RESULTS: Mean body mass index (BMI) at presentation was 26.32 ± 3.52 kg/m² and the mean change in BMI over 6 months was 1.27 ± 0.50 kg/m². 67% of eyes had papilledema of grades 2-3 at the presentation. At the end of 6 months, 75% of eyes had grade 1 papilledema while 13% showed complete resolution. A reduction of 5.32 ± 3.58 in mean deviation (r = 0.316; p-value 0.01) and gain in VER P100 amplitude of 4.2 ± 2.7 µV (r = 0.40; p-value 0.003) were noted over 6 months with reduction in BMI over 6 months. A statistically significant reduction in optic disc height (ODH) was noticed with BMI reduction over 6 months (p = 0.0007; r = 0.45).A reduction of 1.72 ± 0.90 kg/m² (equivalent to 6.53% weight loss) in BMI was associated with a four-grade change in clinical grading of papilledema.
CONCLUSIONS: Reduction in BMI had a significant impact on both structural and functional parameters of the optic nerve in IIH. The involvement of a well-certified dietician should be an integral part of treatment in IIH.
摘要：
目的：评估减轻体重对特发性颅内高压（IIH）乳头水肿确定病例中视神经结构和功能参数的影响。
方法：一项前瞻性观察性研究，在2019年12月至2021年2月的IIH早期和已确定的乳头水肿病例中进行。功能参数(视力、对比敏感度,平均偏差，VER),结构参数(RNFL，GCL-IPL,和光盘高度)，并在基线和每6周测量乳头水肿的临床分级，共6个月。所有患者均接受药物（口服乙酰唑胺）和饮食治疗。
结果：报告时的平均体重指数（BMI）为26.32±3.52kg/m²，6个月内BMI的平均变化为1.27±0.50kg/m²。67％的眼睛在演示中有2-3级的乳头水肿。在六个月结束时，75％的眼睛有1级乳头水肿，而13％的眼睛显示完全消退。在6个月内，发现平均偏差降低了5.32±3.58（r=0.316；p值0.01），VERP100振幅增加了4.2±2.7µV（r=0.40；p值0.003），BMI降低了6个月。在6个月内，随着BMI的降低，视盘高度（ODH）的统计学显着降低（p=0.0007；r=0.45）。BMI降低1.72±0.90kg/m²（相当于体重减轻6.53％）与乳头水肿临床分级的四级变化有关。
结论：降低BMI对IIH患者视神经的结构和功能参数均有显著影响。经过充分认证的营养师的参与应成为IIH治疗的组成部分。
方法：一项前瞻性观察性研究，在2019年12月至2021年2月的IIH早期和已确定的乳头水肿病例中进行。功能参数(视力、对比敏感度,平均偏差，VER),结构参数(RNFL，GCL-IPL,和光盘高度)，并在基线和每6周测量乳头水肿的临床分级，共6个月。所有患者均接受药物（口服乙酰唑胺）和饮食治疗。
结果：报告时的平均体重指数（BMI）为26.32±3.52kg/m²，6个月内BMI的平均变化为1.27±0.50kg/m²。67％的眼睛在演示中有2-3级的乳头水肿。在六个月结束时，75％的眼睛有1级乳头水肿，而13％的眼睛显示完全消退。在6个月内，发现平均偏差降低了5.32±3.58（r=0.316；p值0.01），VERP100振幅增加了4.2±2.7µV（r=0.40；p值0.003），BMI降低了6个月。在6个月内，随着BMI的降低，视盘高度（ODH）的统计学显着降低（p=0.0007；r=0.45）。BMI降低1.72±0.90kg/m²（相当于体重减轻6.53％）与乳头水肿临床分级的四级变化有关。
结论：降低BMI对IIH患者视神经的结构和功能参数均有显著影响。经过充分认证的营养师的参与应成为IIH治疗的组成部分。
