Department of Neuro-ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
Curr Opin Ophthalmol. 2018 Nov;29(6):495-502. doi: 10.1097/ICU.0000000000000518.
We aim to provide a comprehensive and updated review on idiopathic intracranial hypertension (IIH), including the most current studies and treatment options. Special focus will be put on recent theories about the pathophysiology, and on newer prospective studies on treatment modalities.
The Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) provided evidence supporting acetazolamide as a well tolerated first-line therapy in IIH patients with mild vision loss. Recent studies have shown venous sinus stenting as a well tolerated and effective surgical alternative for patients with refractory IIH.
Idiopathic intracranial hypertension is a vision-threatening disorder that predominantly affects obese women of childbearing age. This disorder is becoming more prevalent as the obesity epidemic continues to increase. As our understanding of this disorder continues to evolve, diagnosis and management approaches have changed over time. However, the pathogenesis for IIH remains unclear. Several theories have been proposed, including abnormalities in cerebrospinal dynamics, metabolic causes and genetics. The diagnostic criteria are based on the revised Dandy criteria. Traditionally, treatment was based on clinical experiences and retrospective studies. However, a new, prospective, randomized, controlled trial, the IIHTT, provided evidence-based data to help guide medical therapy. Additionally new, prospective studies are underway for the different surgical alternatives to treat IIH.
本文旨在提供特发性颅内高压（IIH）的全面且最新的综述，包括最新的研究和治疗选择。特别关注最近关于病理生理学的理论，以及关于治疗方式的新前瞻性研究。
特发性颅内高压治疗试验（IIHTT）为乙酰唑胺作为 IIH 伴有轻度视力丧失患者的一线耐受良好的治疗方法提供了证据。最近的研究表明，静脉窦支架置入术是难治性 IIH 患者耐受良好且有效的手术替代方法。
特发性颅内高压是一种威胁视力的疾病，主要影响肥胖的育龄妇女。随着肥胖症的流行持续增加，这种疾病的发病率也在增加。随着我们对这种疾病的认识不断发展，诊断和管理方法也随着时间的推移而发生了变化。然而，IIH 的发病机制仍不清楚。已经提出了几种理论，包括脑脊液动力学异常、代谢原因和遗传原因。诊断标准基于修订后的 Dandy 标准。传统上，治疗基于临床经验和回顾性研究。然而，一项新的、前瞻性、随机、对照试验——IIHTT 提供了基于证据的数据，以帮助指导药物治疗。此外，针对不同的手术治疗 IIH 的替代方法正在进行新的前瞻性研究。
