Kupersmith M J, Gamell L, Turbin R, Peck V, Spiegel P, Wall M
Beth Israel Medical Center, New York Eye and Ear Infirmary, New York 10128, USA.
Neurology. 1998 Apr;50(4):1094-8. doi: 10.1212/wnl.50.4.1094.
To determine the role of weight loss in the treatment of idiopathic intracranial hypertension (IIH) in obese women.
Chart review of 250 patients with suspected IIH revealed 58 women who met our criteria, did not undergo early surgical intervention, and had adequate documentation of visual status, papilledema, and weight at the baseline evaluation and at 6 months or longer. Patients were divided into two groups based on whether weight loss > or = 2.5 kg occurred during any 3-month interval. Papilledema grade, visual acuity, and visual field grade at 6 months or longer and the time to improve each were recorded.
Mean time in months to improve one grade for papilledema and visual field in one eye was 4.0 versus 6.7 (p = 0.013) and 4.6 versus 12.2 (p = 0.032), respectively, for the 38 patients with weight loss compared with the 20 patients with no weight loss. Papilledema resolved in 28/38 with weight loss (mean, 7.6 months) and 8/20 without weight loss (mean, 10.2 months; p = 0.352). There were no differences in final visual acuity or visual field between the two groups, but the papilledema grade was slightly better in the worst eye in each patient at baseline in the weight loss group (p = 0.03).
Weight reduction is associated with more rapid recovery of both papilledema and visual field dysfunction in patients with IIH compared with those who do not lose weight.
确定体重减轻在肥胖女性特发性颅内高压（IIH）治疗中的作用。
对250例疑似IIH患者的病历进行回顾，发现58例女性符合我们的标准，未接受早期手术干预，且在基线评估以及6个月或更长时间时具有充分的视力、视乳头水肿和体重记录。根据在任何3个月间隔内体重是否减轻≥2.5 kg将患者分为两组。记录6个月或更长时间时的视乳头水肿分级、视力和视野分级以及各自改善的时间。
与20例未减重患者相比，38例减重患者视乳头水肿和单眼视野改善一个等级的平均月数分别为4.0对6.7（p = 0.013）和4.6对12.2（p = 0.032）。38例减重患者中有28例（平均7.6个月）视乳头水肿消退，20例未减重患者中有8例（平均10.2个月；p = 0.352）。两组最终视力或视野无差异，但减重组患者基线时每例最差眼中的视乳头水肿分级略好（p = 0.03）。
与未减重的患者相比，减重与IIH患者视乳头水肿和视野功能障碍的更快恢复相关。
