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Published on: April 24, 2020
Risk Factors for Poor Visual Outcomes Among Males with Idiopathic Intracranial Hypertension (IIH)
Jacqueline K Shaia1,2,3, Jeffrey Chu2, Taseen Alam2
1Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
Insights
Idiopathic intracranial hypertension (IIH) affects more women, but males with IIH face higher risks of poor visual outcomes. Smoking, diabetes, and hypertension are key risk factors for vision loss in men with IIH.
Area of Science:
- Neurology
- Ophthalmology
Background:
- Idiopathic intracranial hypertension (IIH) predominantly affects women of reproductive age.
- However, approximately 10% of patients diagnosed with IIH are male.
Purpose of the Study:
- This study aimed to evaluate male patients diagnosed with IIH.
- The primary objective was to identify risk factors associated with poor visual outcomes in this demographic.
Main Methods:
- The study included male patients diagnosed with IIH or papilledema between June 2012 and September 2023.
- Data on demographics, treatments, and outcomes were collected and analyzed, stratifying patients by visual outcomes.
Main Results:
- Male IIH patients constituted 11.2% of the total cohort.
- Post-pubertal males had a higher rate of poor visual outcomes (12.9%) compared to females (7.9%).
- Risk factors for poor visual outcomes in males included current/former smoking, diabetes, and hypertension.
Conclusions:
- While men are a minority of IIH patients, they appear to have a greater likelihood of poor visual outcomes compared to women.
- Poor baseline vision, smoking history, diabetes, and hypertension are significant prognostic indicators for visual impairment in males with IIH.
Abstract:
Although idiopathic intracranial hypertension (IIH) mainly impacts women of a reproductive age, approximately 10% of IIH patients are males. The purpose of this study was to evaluate male IIH with the aim of identifying risk factors for poor visual outcomes. Patients who met the revised Dandy Criteria and received an ICD code of IIH or papilledema at a single tertiary institution between June 2012 and September 2023 were included in this study. Demographics, treatment, and outcomes data were collected, and patients were stratified based on final visual outcomes. Statistical analyses including risk ratio (RR) calculations utilized a p value of <0.05. Male IIH patients composed 11.2% (n = 84) of patients and post-pubertal men had a mean age of 29.37 (SD 13.28). The majority of the population was white at 73% with 5.5% of patients presenting with fulminant IIH. When compared to female IIH patients, 7.9% of females had a poor visual outcome compared to 12.9% of post-pubertal males. Distinct risk factors for post-pubertal male poor visual outcomes include current/former smoker, history of diabetes, and hypertension (p < .05). Although men continue to comprise a small proportion of IIH patients, they may be more likely to have poor visual outcomes than female IIH patients. Prognostic indicators for poor visual outcomes among males may include having poor baseline vision, being a current or former smoker, and having diabetes or hypertension history. Multi-institutional and longitudinal research studies are needed to further explore potential risk factors for poor visual outcomes.
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