Influence of Intraoperative Trendelenburg Positioning and Pneumoperitoneum on Visual Function
Investigating Surgical Positions and Their Impact on Vision in Idiopathic Intracranial Hypertension
Devon Mackay
Primary Investigator
Brief description of study
What is the purpose of this study?
This study is being done because we want to find out whether certain surgical positions, like Trendelenburg positioning (TP) or pneumoperitoneum (PP), could make optic nerve swelling (papilledema) or vision problems worse in people with idiopathic intracranial hypertension (IIH).
Detailed description of study
What will happen during the study?
Testing that will be performed by IUH Ophthalmology staff or technicians at the primary study location (IU Neuroscience Center, Suite 3200, 355 W 15th St, Indianapolis, IN 46202). Parking at the Neuroscience Center is a nominal amount (approximately $5) that will be compensated for by study staff.
Testing includes (in both eyes):
- Optical Coherence Tomography (OCT) of the retinal nerve fiber layer (RNFL)
- OCT of the ganglion cell complex (GCC)
- OCT of the macula
- Fundus photography
- Snellen Visual acuity at distance
- Pupil examination
The study participant will need to be able and willing to take part in the above testing which will involve approximately 10 minutes of total procedure time, and 5-10 minutes of navigating into the testing area, waiting for technician availability, etc.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Idiopathic Intracranial Hypertension, IIH
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Age: 17 years or below
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Gender: All
Inclusion Criteria
• Patients with Idiopathic Intracranial Hypertension (IIH) diagnosed by Modified Dandy Criteria
• Undergoing urologic or gynecologic surgery involving TP of at least 20 degrees declination and/or pneumoperitoneum insufflation of at least 12mmHg for any length of time
• Patients must have true papilledema documented by previous optometrist, Ophthalmologist, or Neuro-ophthalmologist
Exclusion Criteria
• Patients with optic disc edema from any etiology other than IIH
• Unable to attend preoperative and postoperative visit
This study investigates how certain surgical positions, such as Trendelenburg positioning (TP) and pneumoperitoneum (PP), might affect the optic nerve and vision in people with idiopathic intracranial hypertension (IIH). Idiopathic intracranial hypertension is a condition where the pressure around the brain increases, which can lead to optic nerve swelling known as papilledema, and vision problems. The study aims to understand if these surgical practices worsen these symptoms.
During the study, participants will undergo several eye tests performed by IUH Ophthalmology staff at the IU Neuroscience Center. These tests include Optical Coherence Tomography (OCT) of the retinal nerve fiber layer, ganglion cell complex, macula, fundus photography, Snellen visual acuity tests, and pupil examinations. These procedures will take approximately 10 minutes, with additional time for preparation and waiting.
- Who can participate: Participants must have idiopathic intracranial hypertension diagnosed by the Modified Dandy Criteria and be undergoing urologic or gynecologic surgery involving specific surgical positions. They must also have documented papilledema.
- Study details: Participants will undergo a series of eye examinations to assess the impact of surgical positions on their vision. These tests are non-invasive and involve imaging and visual acuity assessments.
