Sleep apnea and intracranial hypertension in men

Document Type

Article

Abstract

PURPOSE: To investigate sleep apnea as an associated finding in idiopathic intracranial hypertension (IIH) in men. DESIGN: Multicenter, retrospective, noncomparative interventional case series. METHODS: Retrospective review of all men with the diagnosis of IIH seen within the last 5 years at three tertiary care academic ophthalmologic institutions. Cases with sleep apnea (SA) and IIH were identified and reviewed. RESULTS: Thirty-two cases of IIH in men were reviewed. Six cases with SA met the modified Dandy criteria for the diagnosis of IIH. Of these six patients, one received acetazolamide alone, four received acetazolamide and continuous positive airway pressure (CPAP), and one was treated with CPAP alone. All patients had preserved central acuity (20/20 or better in both eyes), enlarged blind spots, and optic disc edema in both eyes. Five patients had normal visual fields after treatment, and one patient had residual visual field loss. Three patients had normal optic nerve examinations, with resolution of the optic disc edema at last follow-up. After resolution of the optic disc edema, these three patients were maintained on CPAP but discontinued acetazolamide. Two patients had persistent but improved papilledema and are under continued treatment with acetazolamide and CPAP. One patient had optic disc pallor in both eyes and is stable. CONCLUSIONS: SA was a common finding in men meeting the modified Dandy criteria for IIH in adults. Treatment of sleep apnea with nocturnal oxygenation may improve the signs and symptoms of IIH in affected men.

Medical Subject Headings

Acetazolamide (therapeutic use); Adult; Carbonic Anhydrase Inhibitors (therapeutic use); Humans; Intracranial Pressure; Male; Middle Aged; Papilledema (drug therapy); Positive-Pressure Respiration; Pseudotumor Cerebri (complications, diagnosis, therapy); Retrospective Studies; Sleep Apnea Syndromes (complications, diagnosis, therapy); Visual Acuity; Visual Fields

Publication Date

3-1-2002

Publication Title

Ophthalmology

ISSN

0161-6420

Volume

109

Issue

3

First Page

482

Last Page

5

PubMed ID

11874748

Digital Object Identifier (DOI)

10.1016/s0161-6420(01)00987-3

Link to Full Text

Share

COinS