Visual Loss in Raised Intracranial Pressure Associated with Severe Vitamin A Deficiency

Idiopathic Intracranial Hypertension (IIH) is a disorder characterized by raised intracranial pressure without evidence of another cause such as infection, space occupying lesion or vascular abnormality. The incidence of IIH seems to be increasing amongst adolescent children, but the pathogenesis of the disease still remains unclear. We report a case of visual loss with raised intracranial pressure, and retinal dysfunction associated with unrecordable levels of vitamin A in a child. A twelve year old boy presented with reduced vision; on examination there was bilateral papilloedema. Investigations showed raised intra-cranial pressure and rod-cone dysfunction on electrophysiology but normal appearances on the CT and MRI head. This pathologic pattern was attributed to idiopathic intracranial hypertension associated with severe Vitamin A deficiency. This case highlights the importance of considering malnutrition, when confronted with the dual presentation of raised intracranial pressure and retinal dysfunction. Olaoluwakitan A Osunkunle1, Robert MJ Purbrick1,2 and Susan M Downes1,3* 1Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, UK 2Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, UK 3Nuffield Department of Ophthalmology, University of Oxford, UK Susan M Downes, et al., Annals of Clinical Case Reports Ophthalmology Remedy Publications LLC., | http://anncaserep.com/ 2017 | Volume 2 | Article 1261 2 fingers left. Repeat electrophysiology at three months showed bilateral significant improvement.