• Written By: Howard Pomeranz, MD, PhD
    Neuro-Ophthalmology/Orbit

    The results of this retrospective study of 82 patients with idiopathic intracranial hypertension (IIH) confirmed the strong association between being overweight and IIH.

    The study included women after menarche and men older than 18 years of age who were followed for at least one year. The mean follow-up time was 61.3 months.

     The predominant presenting symptoms were headache, transient visual obscurations, tinnitus and diplopia. Eighty-two percent of patients were overweight at the time of diagnosis, with a mean body mass index of 31.6 ± 6.7 kg/m2, with many patients reporting significant weight gain during the preceding year.

    Overweight patients had higher CSF opening pressure than patients with normal weight. The grade of papilledema correlated with CSF opening pressure. There was an inverse correlation between the depression of the visual field sensitivity and the grade of papilledema.

    Eighty-four percent of patients improved with follow-up while in 22 percent CSF diversion procedures or optic nerve sheath fenestration were required. Sixty-seven percent of patients suffered a recurrence of IIH.

    While the mean BMI of patients in this study decreased, they still were overweight at the end of follow-up. The authors do not recommend diet modification as a sole treatment option even in mild cases, and they treat every patient medically once the diagnosis has been established.