Visual loss in pseudotumor cerebri of childhood. A follow-up study
R. S. Baker, D. Carter, E. B. Hendrick and J. R. Buncic
The occurrence of visual loss in substantial numbers of adult patients with
pseudotumor cerebri is well recognized. In children, the disease has been
said to spare the visual system. We evaluated the ophthalmologic features
of 36 children with pseudotumor cerebri followed up for one to 12 years.
Four patients had rapid, severe loss of visual acuity and visual field
changes while receiving medical therapy. Six others had less-severe but
prominent abnormalities of visual acuity and/or visual fields at some point
during the disease process. Only one patient had a permanent, severe visual
impairment, but five had moderate permanent visual abnormalities. A severe
degree of papilledema was seen only in the group with visual loss, but some
patients in this group had only moderate papilledema. More patients with
dural sinus thrombosis had serious visual loss than did those with other
associated diseases or idiopathic pseudotumor cerebri. Quantitative
perimetry of some sort can be performed in most children and is the
preferred sequential test for planning treatment.
