Clinical Characteristics of Idiopathic Intracranial Hypertension in Patients Over 50 Years of Age: A multicenter clinical cohort study

Peter A. Downie, John J. Chen, M. Tariq Bhatti, Andrew T. Melson, Gregory P. Van Stavern, Collin McClelland, Bruce R. Lindgren, Jibran A. Sharieff, Michael S. Lee

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To characterize the clinical features of idiopathic intracranial hypertension (IIH) in patients >50 years of age compared to the typical IIH population and existing data for this older cohort. Design: Retrospective, clinical cohort study. Methods: Medical records of 65 patients >50 years of age at first diagnosis of IIH were reviewed based on the Modified Dandy Criteria from 4 academic centers. Each center provided randomly selected controls from IIH patients <50 years of age for each study patient at their location. Data recorded included patient demographics, presenting symptoms, medications, coexisting medical conditions, cerebrospinal fluid (CSF) opening pressure, treatments, and neuro-ophthalmic data from initial and final visits. Results: Compared to controls, the older cohort showed the following characteristics: fewer females (n = 51 [78.5%] vs. controls: n = 60 [92.3%]; P =.045), fewer headaches (n = 33 [50.8%] vs. controls: 52 [80.0%]; P =.001), more frequent incidental discoveries of papilledema (n = 19 [29.2%] vs. controls: 7 [10.8%]; P =.015), and lower CSF opening pressure [median: 33 cm H2O [range: 21-58 cm H2O] vs. the median for controls: 34 cm H2O [range: 24-67 cm H2O; P =.029). Conclusions: Patients with IIH diagnosed at >50 years of age were less often female and had lower CSF opening pressure, fewer headaches, a higher chance of incidentally identified papilledema, and body mass index similar to that of younger IIH patients. Older IIH onset was not associated with worse visual outcome.

Original languageEnglish (US)
Pages (from-to)96-101
Number of pages6
JournalAmerican journal of ophthalmology
Volume224
DOIs
StatePublished - Apr 2021

Bibliographical note

Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. This research was supported by the US National Institutes of Health , United States/ National Center for Advancing Translational Sciences , United States grant UL1TR002494 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health/National Center for Advancing Translational Sciences. C.M.M. is a consultant for Horizon Therapeutics. M.S.L. is a consultant and holds stock in Horizon Therapeutics, Osmotica Pharmaceuticals, Royalties, and Springer Publishing. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. This research was supported by the US National Institutes of Health, United States/National Center for Advancing Translational Sciences, United States grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health/National Center for Advancing Translational Sciences. C.M.M. is a consultant for Horizon Therapeutics. M.S.L. is a consultant and holds stock in Horizon Therapeutics, Osmotica Pharmaceuticals, Royalties, and Springer Publishing. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

PubMed: MeSH publication types

  • Journal Article

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