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The idiopathic intracranial hypertension treatment trial: clinical profile at baseline

Michael Wall1, Mark J Kupersmith2, Karl D Kieburtz3

  • 1Department of Neurology, University of Iowa, Iowa City2Department of Ophthalmology, University of Iowa, Iowa City.

JAMA Neurology
|April 24, 2014
PubMed

Insights

Idiopathic intracranial hypertension (IIH) predominantly affects obese young women. This study characterized IIH patients, revealing common symptoms like headache and visual field defects requiring formal perimetry for diagnosis.

Area of Science:

  • Neurology
  • Ophthalmology
  • Clinical Research

Background:

  • Idiopathic intracranial hypertension (IIH) lacks large prospective cohort data for disease characterization.
  • The Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) was established to address this knowledge gap.

Purpose of the Study:

  • To report the baseline clinical and laboratory features of patients enrolled in the IIHTT.
  • To characterize the disease in a large cohort of untreated IIH patients.

Main Methods:

  • 165 patients meeting modified Dandy criteria for IIH were enrolled across 38 North American sites.
  • Data collected via questionnaires, examinations, automated perimetry, and fundus photography.
  • Inclusion criteria included perimetric mean deviation between -2 dB and -7 dB; most participants were women.

Main Results:

  • The cohort comprised predominantly young, obese women (mean age 29.0 years, BMI 39.9).
  • Common symptoms included headache (84%), transient visual obscurations (68%), and pulse synchronous tinnitus (52%).
  • Visual field defects, primarily arcuate loss and enlarged blind spots, were prevalent, though visual acuity was often preserved.

Conclusions:

  • IIH is primarily a disease of obese young women.
  • Patients with mild visual loss present with characteristic symptoms and specific visual field defects.
  • Formal perimetry is essential for detecting subtle visual field abnormalities in IIH.
Abstract

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