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Characterizing and Predicting Visual Outcomes in Adults, Fulminant, and Pediatric Idiopathic Intracranial Hypertension
Characterizing and Predicting Visual Outcomes in Adults, Fulminant, and Pediatric Idiopathic Intracranial Hypertension
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202105707
- ISBN
- 9798265447753
- DDC
- 610
- 서명/저자
- Characterizing and Predicting Visual Outcomes in Adults, Fulminant, and Pediatric Idiopathic Intracranial Hypertension
- 발행사항
- [Sl] : Case Western Reserve University, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 176 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 87-06, Section: B.
- 주기사항
- Advisor: Dolansky, Mary.
- 학위논문주기
- Thesis (Ph.D.)--Case Western Reserve University, 2025.
- 초록/해제
- 요약Idiopathic intracranial hypertension, or IIH, is an understudied vision threatening neurological condition mainly affecting women of a reproductive age. Although initially described in 1893, IIH has been poorly studied with few analyses evaluating risk factors of vision loss. Further, there is little published information on atypical forms of IIH, including being a pediatric, male, or fulminant patients (rapid visual degradation occurring within one month of symptom onset), and their longitudinal outcomes. This dissertation aimed to characterize and predict longitudinal visual outcomes among adult, pediatric, and fulminant IIH patients. This study first utilized a large aggregate healthcare platform called TriNetX (with over 85 million patients) to evaluate the prevalence of IIH within the United States. Next, electronic health records from the Cleveland Clinic Cole Eye institute were screened for IIH patients(n=719). Patients baseline IIH characteristics and longitudinal outcomes were characterized. Additionally, the incidence of IIH first occurring during pregnancy was evaluated. Lastly, a prediction algorithm anticipating long-term visual loss at a patients baseline visit was created in R Studio. Within TriNetX, the prevalence of IIH increased 35% from 2015 to 2022 while predominantly impacting Black and Hispanic/Latin females. The rest of the analyses were conducted utilizing Cole Eye electronic health records. Fulminant IIH remained a rare presentation (3.2% incidence) with devastating visual loss with 42% of patients being legally blind(defined as 20/200 best visual acuity (BVA) and 42% having moderate visual impairments. Prepubertal and post-pubertal disease were found to have distinct presentations, but comparable visual outcomes, with few having a poor visual outcome (visual field mean deviation of -7 dB or worse in at least one eye or if they had a BVA worse than or equal to 20/80 in at least one eye). The incidence of IIH first occurring in pregnancy was 6.5%. Lastly, our novel algorithm, which predicted poor visual outcomes at IIH diagnosis, stratified patients into four prognostic groups: Critical, High, Medium, and Low Risk. Critical risk was defined as patients with a visual field mean deviation worse than -9.1dB resulting in a 69.8% risk of a poor visual outcome. This risk was further increased if they identified as a minority race or ethnicity. Overall, IIH is an increasing condition predominantly impacting minority women. Our work both characterized disease onset and observed longitudinal outcomes while providing clinicians with valuable prognostic markers to assist in identifying patients who are at critical risk for significant vision loss.
- 일반주제명
- Medicine
- 일반주제명
- Neurosciences
- 일반주제명
- Pediatrics
- 키워드
- Vision loss
- 키워드
- Papilledema
- 기타저자
- Case Western Reserve University Clinical Translational Science
- 기본자료저록
- Dissertations Abstracts International. 87-06B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■00520260202105707
■006m o d
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■020 ▼a9798265447753
■035 ▼a(MiAaPQ)AAI32432474
■035 ▼a(MiAaPQ)OhioLINK:case1743608737570403
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a610
■1001 ▼aShaia, Jacqueline K.
■24510▼aCharacterizing and Predicting Visual Outcomes in Adults, Fulminant, and Pediatric Idiopathic Intracranial Hypertension
■260 ▼a[Sl]▼bCase Western Reserve University▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a176 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 87-06, Section: B.
■500 ▼aAdvisor: Dolansky, Mary.
■5021 ▼aThesis (Ph.D.)--Case Western Reserve University, 2025.
■520 ▼aIdiopathic intracranial hypertension, or IIH, is an understudied vision threatening neurological condition mainly affecting women of a reproductive age. Although initially described in 1893, IIH has been poorly studied with few analyses evaluating risk factors of vision loss. Further, there is little published information on atypical forms of IIH, including being a pediatric, male, or fulminant patients (rapid visual degradation occurring within one month of symptom onset), and their longitudinal outcomes. This dissertation aimed to characterize and predict longitudinal visual outcomes among adult, pediatric, and fulminant IIH patients. This study first utilized a large aggregate healthcare platform called TriNetX (with over 85 million patients) to evaluate the prevalence of IIH within the United States. Next, electronic health records from the Cleveland Clinic Cole Eye institute were screened for IIH patients(n=719). Patients baseline IIH characteristics and longitudinal outcomes were characterized. Additionally, the incidence of IIH first occurring during pregnancy was evaluated. Lastly, a prediction algorithm anticipating long-term visual loss at a patients baseline visit was created in R Studio. Within TriNetX, the prevalence of IIH increased 35% from 2015 to 2022 while predominantly impacting Black and Hispanic/Latin females. The rest of the analyses were conducted utilizing Cole Eye electronic health records. Fulminant IIH remained a rare presentation (3.2% incidence) with devastating visual loss with 42% of patients being legally blind(defined as 20/200 best visual acuity (BVA) and 42% having moderate visual impairments. Prepubertal and post-pubertal disease were found to have distinct presentations, but comparable visual outcomes, with few having a poor visual outcome (visual field mean deviation of -7 dB or worse in at least one eye or if they had a BVA worse than or equal to 20/80 in at least one eye). The incidence of IIH first occurring in pregnancy was 6.5%. Lastly, our novel algorithm, which predicted poor visual outcomes at IIH diagnosis, stratified patients into four prognostic groups: Critical, High, Medium, and Low Risk. Critical risk was defined as patients with a visual field mean deviation worse than -9.1dB resulting in a 69.8% risk of a poor visual outcome. This risk was further increased if they identified as a minority race or ethnicity. Overall, IIH is an increasing condition predominantly impacting minority women. Our work both characterized disease onset and observed longitudinal outcomes while providing clinicians with valuable prognostic markers to assist in identifying patients who are at critical risk for significant vision loss.
■590 ▼aSchool code: 0042.
■650 4▼aMedicine
■650 4▼aNeurosciences
■650 4▼aPediatrics
■653 ▼aIdiopathic intracranial hypertension
■653 ▼aVision loss
■653 ▼aPseudotumor cerebri
■653 ▼aBenign intracranial hypertension
■653 ▼aPapilledema
■690 ▼a0564
■690 ▼a0767
■690 ▼a0317
■71020▼aCase Western Reserve University▼bClinical Translational Science.
■7730 ▼tDissertations Abstracts International▼g87-06B.
■790 ▼a0042
■791 ▼aPh.D.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17361104▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
