Idiopathic intracranial hypertension (IIH) is a
disorder of raised intracranial pressure (ICP) in the absence
of identifiable pathology. The purpose of this study was to
evaluate the clinical presentation and monitor a 3-month
course using frequent optical coherence tomography (OCT)
evaluations, visual field testings and lumbar opening
pressure measurements. A longitudinal study of 17 patients
with newly diagnosed IIH and 20 healthy overweight
controls were included in the study. Peripapillary retinal
nerve fiber layer thickness (RNFLT) and retinal thickness
(RT) measurements (Stratus OCT-3, fast RNFL 3.4 protocol),
and Humphrey visual field testing were evaluated at
regular intervals. Repeat lumbar puncture was performed at
final visit (n = 13). The diagnostic delay was 3 months
and initial symptoms were headache (94%), visual blurring
(82%) and pulsatile tinnitus (65%). Complete clinical
remission was achieved in 65%, partial in 29% and
unchanged symptoms in 6%. Total average RNFLT and RT
decreased significantly during the follow-up period
(p\0.0001 and p\0.0001, respectively). Changes in
RNFLT and RT correlated with improvements in visual
field mean deviation (MD) (RNFLT: p = 0.006; RT:
p = 0.03) and pattern standard deviation (PSD) (RNFLT:
p = 0.002; RT: p = 0.003). In patients with weight-loss
[3.5% of BMI, ICP decreased significantly (p = 0.0003).
In patients with weight-loss\3.5% of BMI, changes in ICP
were insignificant (p = 0.6). OCT combined with visual
field testing may be a valuable objective tool to monitor
IIH patients and the short term IIH outcome is positive.
Weight-loss is the main predictor of a favorable outcome
with respect to CSF pressure.