Risk Factors for Poor Visual Outcomes Among Males with Idiopathic Intracranial Hypertension (IIH)

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.