NEGATIVE IMPACT OF COVID-19 LOCKDOWN ON PAPILLOEDEMA AND IDIOPATHIC INTRACRANIAL HYPERTENSION

ABSTRACT

Background Enforced national lockdown due to COVID-19 limited access to medical services. We evaluated the impact on those presenting with papilloedema, and those with a preexisting diagnosis of idiopathic intracranial hypertension. Design A single United Kingdom centre prospective cohort study between May 15, 2020 (start of emergency clinics after first 8 week national lockdown) and July 31, 2020. Demographics, diagnosis and outcomes were documented. Results The study recorded 130 individual patients, 123 with a diagnosis of idiopathic intracranial hyper-tension. 92% were female and mean age was 32.5 years. Emergency cerebrospinal fluid diversion surgery was required in 13% (17/130), a 4.7-fold (367%) increase compared to the same period in 2019. Weight increased in 58% (mean 6.2kg SD 4.6) and corresponded to a significant increase in papilloedema (Optical Coherence Tomography retinal nerve fibre layer 15mm SD 57.3, p=0.014). Elevated anxiety levels (hospital anxiety and depression scale >7) occurred in 64%. Conclusions There was a 367% increase in emergency shunting to save vision in idiopathic intracranial hypertension following national lockdown. Worsening of papilloedema, weight gain, and detrimental effects on mental health were recorded. Countermeasures should be implemented to minimise harm in this rare disease during future service restrictions and lockdowns.