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This Article Full Text Full Text (PDF) CME: Take the course for this article: Volume 72, Number 4, January 27, 2009 Japanese Translation All Versions of this Article: 01.wnl.0000333254.84120.f5v1 72/4/304    most recent Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bruce, B. B. Articles by Biousse, V. Search for Related Content PubMed PubMed Citation Articles by Bruce, B. B. Articles by Biousse, V. Related Collections Idiopathic intracranial hypertension Visual loss Risk factors in epidemiology Related Article

Idiopathic intracranial hypertension in men

From the Departments of Ophthalmology (B.B.B., N.J.N., V.B.), Neurology (N.J.N., V.B.), and Neurological Surgery (N.J.N.), Emory University, Atlanta, GA; Departments of Neurology (S.K., D.M., J.J.C.) and Ophthalmology (J.J.C.), University of Mississippi, Jackson, MS; Department of Ophthalmology (G.P.V.S.), Wayne State University, Detroit, MI; Department of Ophthalmology (M.D.A.), Louisiana State University, New Orleans, LA; Department of Ophthalmology (R.A.B.), University of Alabama, Birmingham, AL; and Department of Ophthalmology (P.P.), Ramathibodi Hospital, Mahidol University, Thailand.

Address correspondence and reprints to Dr. Valérie Biousse, Neuro-ophthalmology Unit, Emory Eye Center, 1365-B Clifton Rd., NE, Atlanta, GA 30322 vbiouss{at}emory.edu

Objective: To compare the characteristics of idiopathic intracranial hypertension (IIH) in men vs women in a multicenter study.

Methods: Medical records of all consecutive patients with definite IIH seen at three university hospitals were reviewed. Demographics, associated factors, and visual function at presentation and follow-up were collected. Patients were divided into two groups based on sex for statistical comparisons.

Results: We included 721 consecutive patients, including 66 men (9%) and 655 women (91%). Men were more likely to have sleep apnea (24% vs 4%, p < 0.001) and were older (37 vs 28 years, p = 0.02). As their first symptom of IIH, men were less likely to report headache (55% vs 75%, p < 0.001) but more likely to report visual disturbances (35% vs 20%, p = 0.005). Men continued to have less headache (79% vs 89%, p = 0.01) at initial neuro-ophthalmologic assessment. Visual acuity and visual fields at presentation and last follow-up were significantly worse among men. The relative risk of severe visual loss for men compared with women was 2.1 (95% CI 1.4–3.3, p = 0.002) for at least one eye and 2.1 (95% CI 1.1–3.7, p = 0.03) for both eyes. Logistic regression supported sex as an independent risk factor for severe visual loss.

Conclusion: Men with idiopathic intracranial hypertension (IIH) are twice as likely as women to develop severe visual loss. Men and women have different symptom profiles, which could represent differences in symptom expression or symptom thresholds between the sexes. Men with IIH likely need to be followed more closely regarding visual function because they may not reliably experience or report other symptoms of increased intracranial pressure.

Abbreviations: BMI = body mass index; HVF MD = Humphrey visual field mean deviation; IIH = idiopathic intracranial hypertension; MR = magnetic resonance; VA = visual acuity.

Editorial, page 300

e-Pub ahead of print on October 15, 2008, at www.neurology.org.

This study was supported in part by a departmental grant (Department of Ophthalmology) from Research to Prevent Blindness, Inc., New York, NY, and by core grants P30-EY06360 (Department of Ophthalmology) from the National Institutes of Health, Bethesda, MD. N.J.N. is a recipient of a Research to Prevent Blindness Lew R. Wasserman Merit Award.

Disclosure: The authors report no disclosures.

Received May 13, 2008. Accepted in final form July 18, 2008.

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