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 M. 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

ASJC Scopus subject areas

  • Ophthalmology

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