Purpose We conducted a retrospective study in 20 cases of idiopathic i
ntracranial hypertension (IIH) referred to the ophthalmology out-patie
nts department at the Centre Hospitalier Universitaire of Fort de Fran
ce. The objectives were to characterize symptomatology, severity, dise
ase course and to discuss treatment. Methods We performed a complete o
phthalmological and neurological examination, calculated the body mass
index (BMI) and evaluated visual field. Each patient underwent a CT s
can with injection and a lumbar punction with measurement of cerebrosp
inal fluid pressure. We also specified the treatment chosen and its du
ration, and the number of recurrences. Results This study included 20
cases, 19 women and 1 man, with a mean follow-up of 28.6 months. The a
verage BMI was of 32.2 kg/m2. Fifteen patients out of 20 were obese (7
5%), all of them women, so 79% of the women were obese. Sixteen patien
ts had headache (80%), 15 a loss of visual acuity (75%) and 5 transien
t visual loss (25%). For all the clinical examination showed bilateral
papilloedema. Visual field disturbances were observed in 11 patients
(73.3%). Papilloedema disappeared after medical treatment of a mean 2.
4 months duration for each access. In 9 cases of 18 (50%) recurrences
were observed after gradual treatment with-drawal. Conclusion The long
-term treatment, the side effects, the possible severity of the ocular
disease, the difficulties of dietary restriction and the high rate of
recurrence, would, for us, indicate a need to reconsider surgical tre
atment. We propose to perform lumboperitoneal shunt or optic nerve she
ath-decompression if medical treatment fails at the first onset of IIH
or in case of severe visual loss, pregnancy or recurrence.