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Controversies in Neuro-Ophthalmic Management pp 51–63Cite as

Papilledema

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Abstract

Papilledema refers to optic disc edema due to elevated intracranial pressure (ICP), which should be bilateral although may be very asymmetric in 4% of patients. ICP can be elevated due to increased cerebrospinal fluid (increased production or decreased absorption), increased intracranial blood volume (hemorrhage, acute hypertension, vasodilation, arteriovenous malformation, or fistula), increased cerebral volume (edema or tumor), or decreased intracranial space (increased bone deposition). The most common cause is idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri. While the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) demonstrated class 1 evidence for use of acetazolamide in patients with mild visual field loss and high-grade papilledema, other treatments are available including alternative medications as well as surgeries, and optimal treatment is not yet clear.

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Authors and Affiliations

  1. Division of Neuro-Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Andrew R. Carey

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  1. Division of Neuro-Ophthalmology Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Amanda D. Henderson

  2. Division of Neuro-Ophthalmology Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Andrew R. Carey

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Carey, A.R. (2021). Papilledema. In: Henderson, A.D., Carey, A.R. (eds) Controversies in Neuro-Ophthalmic Management. Springer, Cham. https://doi.org/10.1007/978-3-030-74103-7_6

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