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Rarebit Perimetry in the Evaluation of Visual Field Defects in Idiopathic Intracranial Hypertension

Idiopathic intracranial hypertension (IIH) is the clinical syndrome of raised intracranial pressure without clinical, laboratory, or radiologic evidence of intracranial pathology. Diagnostic criteria were first published by Dandy in 1937 (1). The most recent formulation of the criteria has been published in the International Headache Society’s (IHS) classification of headache disorders, second edition (2). Headache is the most prominent manifestation and it is the presenting symptom in 75%–100% of patients (3, 4). Papilledema is the cardinal finding of the visual examination. Visual field defects appear in up to 96% of patients during the course of IIH (5, 6). Enlargement of blind spot is frequent and has a prevalence of 33% to 93% in patients with IIH, which reflects the degree of optic disc swelling (6). Peripheral rim constriction, nasal steps, and arcuate scotomas are the other most typical defects indicating nerve fiber loss (7). Standard automated perimetry (SAP) is used extensively to identify and monitor visual field abnormalities in patients with IIH. SAP determines the minimum luminance needed to detect a static white light stimulus Rarebit perimetry in the evaluation of visual field defects in idiopathic intracranial hypertension