Evaluation of eye symptoms during cerebrospinal fluid leakage

Abstract

We investigated subjective symptoms, ophthalmic findings, accommodation power, and accommodation tension/relaxation time in 28 cases of intracranial hypotension syndrome. TriIRIS and ARK-1were performed in cases without visual acuity or field disturbance. Ophthalmic symptoms included ocular pain(74.1％), out-of-focus(60.7％), monocular diplopia (42.9％), binocular diplopia(35.7％), visual acuity disturbance(28.5％), photophobia(25.0％), and visual field defects(7.1％). No abnormalities were observed in the eyes of patients with visual acuity disturbances. Afferent visual field defects were found in half of the cases with visual field disturbances. The accommodation power were lower than the average age in 75％ cases. The visual symptoms improved in all cases after infusion therapy, and 2/3 cases showed improved gaze tracking and decreased blinks during convergence in TriIRIS. However, none of the cases displayed any changes in the ARK-1test. Improvement in the visual appearance after infusion therapy for intracranial hypotension syndrome might be because of enhancement in the function of the convergence reflex.