Abstract
PURPOSE: A surge in the number of cases of fulminant idiopathic intracranial hypertension (IIH) was observed within 1 year of the lockdown due to coronavirus disease 2019 (COVID-19) in March 2020. This study aims to describe the characteristics, outline of management, and final visual outcome for six cases diagnosed with fulminant IIH. METHODS: We reviewed the medical records of six adult patients diagnosed with fulminant IIH, between May and November 2021, based on their presentation at the University of Ottawa, Eye Institute. RESULTS: All six patients were diagnosed with fulminant IIH (five females and one male). Five out of six patients were obese and one patient was overweight. Medical treatment included the administration of acetazolamide (2-4 g/day) to all patients and intravenous methylprednisolone in four patients. Surgical treatment (optic nerve sheath fenestration) was performed for all patients. Visual function improved for three out of the six patients, two patients remained stable, and one patient got worse. CONCLUSION: There has been a recent surge in the number of cases of fulminant IIH in the COVID-19 lockdown period. The negative impact of COVID-19 on health led to an increase in weight, which is thought to have played a role in this recent increase in fulminant IIH cases. Urgent surgery, coupled with acetazolamide administration, is recommended for such patients. Patient compliance and close follow-up are recommended for early detection of relapse.