The proposed study aims to evaluate optic nerve head blood flow and microcirculation in patients with idiopathic intracranial hypertension. For this purpose, optic nerve head blood flow will be examined in patients with IIH before and after therapy and additionally compared with healthy age- and sex-matched control subjects. In addition, other parameters will be measured, in particular retinal blood flow, retinal oxygen saturation and retinal neurovascular coupling.
Idiopathic intracranial hypertension (IIH) is a neuroophthalmological disease, characterized by an increased intracranial pressure (ICP) without an identifiable causative factor. If not properly treated and carefully monitored the disease can even lead to irreversible severe or complete loss of vision or severe irreversible visual field defects, respectively. Given this clinical urgency, precise diagnostic tools become essential for timely decision making. Laser Speckle Flowgraphy (LSFG) is a non-invasive, in-vivo imaging method, which quantitatively estimates blood flow in the optic nerve head, the choroid, the retina and the iris. LSFG has a low procedural complexity, obtains precise and reproducible measurements and is therefore suitable to assess ocular perfusion. The proposed study aims to evaluate optic nerve head blood flow and microcirculation in patients with idiopathic intracranial hypertension. For this purpose, optic nerve head blood flow will be examined in patients with IIH before and after therapy and additionally compared with healthy age- and sex-matched control subjects. In addition, other parameters will be measured, in particular retinal blood flow, retinal oxygen saturation and retinal neurovascular coupling.
Study Type
OBSERVATIONAL
Enrollment
48
Patients with idiopathic intracranial hypertension will receive lumbar puncture and will be given medication to reduce intracranial pressure by neurologists. The lumbar puncture and the administration of medication are not part of this study, patients would also receive these without participating in the study.
Medical University of Vienna
Vienna, Austria
RECRUITINGOptic nerve head blood flow
Change in optic nerve head blood flow in patients with idiopathic intracranial hypertension before and 6 months after therapy (LSFG).
Time frame: Before the start of the therapy and 6 months after the start of the therapy
Neurovascular coupling
Change in neurovascular coupling in patients with idiopathic intracranial hypertension before and 6 months after therapy (Dynamic Vessel Analyzer, IMEDOS, Jena, Germany)
Time frame: Before the start of the therapy and 6 months after the start of the therapy
Retinal nerve fiber layer thickness
Change in retinal nerve fiber layer thickness in patients with idiopathic intracranial hypertension before and 6 months after therapy.
Time frame: Before the start of the therapy and 6 months after the start of the therapy
Retinal and retinal layer thickness
Change in retinal and retinal layer thickness in patients with idiopathic intracranial hypertension before and 6 months after therapy (OCT).
Time frame: Before the start of the therapy and 6 months after the start of the therapy
Retinal vessel density
Change in retinal vessel density in patients with idiopathic intracranial hypertension before and 6 months after therapy (OCT-A).
Time frame: Before the start of the therapy and 6 months after the start of the therapy
Choroidal vascularity index (EDI-OCT)
Change in choroidal vascularity index (CVI is defined as the ratio of vascular luminal area (LA) to total choroidal area (TCA) and is presented as a percentage) in patients with idiopathic intracranial hypertension before and 6 months after therapy (EDI-OCT).
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Time frame: Before the start of the therapy and 6 months after the start of the therapy
Retinal vessel diameter
Change in retinal vessel diameter (µm) in patients with idiopathic intracranial hypertension before and 6 months after therapy (retinal oximetry).
Time frame: Before the start of the therapy and 6 months after the start of the therapy
Optic nerve head blood flow
Change in optic nerve head blood flow in patients with idiopathic intracranial hypertension before and 6 months after therapy (LDF).
Time frame: Before the start of the therapy and 6 months after the start of the therapy
Retinal oxygen extraction
Change in retinal oxygen extraction in patients with idiopathic intracranial hypertension before and 6 months after therapy (LSFG, retinal oximetry).
Time frame: Before the start of the therapy and 6 months after the start of the therapy
Ocular perfusion pressure and arterial blood pressure
Change in ocular perfusion pressure and arterial blood pressure in patients with idiopathic intracranial hypertension before and 6 months after therapy.
Time frame: Before the start of the therapy and 6 months after the start of the therapy
Retinal oxygen saturation
Retinal oxygen saturation (SO2) in patients with idiopathic intracranial hypertension before and 6 months after therapy (retinal oximetry).
Time frame: Before the start of the therapy and 6 months after the start of the therapy
Choroidal thickness (EDI-OCT)
Change in choroidal thickness (µm) in patients with idiopathic intracranial hypertension before and 6 months after therapy (EDI-OCT).
Time frame: Before the start of the therapy and 6 months after the start of the therapy