The Association Between Anemia and Pseudotumor Cerebri

Contemporary literature suggests that anemia may be a risk factor for the development of pseudotumor cerebri (PTC) and associated with poorer visual outcomes. However, literature describing the association is limited, and whether laboratory testing for anemia should be done during a PTC work-up is frequently debated among neuro-ophthalmologists.

International Classification of Diseases-10 codes were used to identify patients with PTC from the SOURCE database. Patients with PTC were matched for age, sex, and race with controls. Relative rates of anemia were compared between groups. A subgroup analysis compared demographic factors and outcomes for PTC patients with and without anemia.

Two-thousand two-hundred forty patients with PTC and 2,240 age-, race-, body mass index-, and sex-matched controls from a national, multicentered database were included in the study. Rates of anemia did not differ between PTC and non-PTC groups (23.4% vs 22.3%, P = 0.393). Among patients with PTC, anemia was associated with older age at onset (38.0 ± 14.1 vs 36.1 ± 13.6 [27.0-45.0] years, P = 0.013), male sex (16.2% vs 10.7%, P = 0.017), and lower visual acuity at presentation ( P < 0.001), but final visual acuities were similar when controlling for presenting acuity ( P = 0.123).

Using the largest sample of patients with PTC and matched controls to date, anemia was not associated with PTC diagnosis. Among patients with PTC, anemia was associated with demographic features atypical for PTC.