Predictors of Headaches and Quality of Life in Women with Ophthalmologically Resolved Idiopathic Intracranial Hypertension

Author:

Horev Anat12,Aharoni-Bar Sapir3,Katson Mark4,Tsumi Erez5ORCID,Regev Tamir5,Zlotnik Yair12,Biederko Ron6ORCID,Ifergane Gal12,Shelef Ilan27,Eliav Tal8ORCID,Ben-Arie Gal27,Honig Asaf12ORCID

Affiliation:

1. Department of Neurology, Soroka University Medical Center, Beer Sheva 8453227, Israel

2. Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 8453227, Israel

3. Ben-Gurion Medical School, Soroka University Medical Center, Beer Sheva 8453227, Israel

4. Rambam Health Care Campus, Haifa 3109601, Israel

5. Department of Ophthalmology, Soroka University Medical Center, Beer Sheva 8453227, Israel

6. Clinical Research Center, Soroka University Medical Center, Beer Sheva 8453227, Israel

7. Department of Radiology, Soroka University Medical Center, Beer Sheva 8453227, Israel

8. Department of Internal Medicine, Jefferson Einstein Philadelphia Hospital, Philadelphia, PA 19141, USA

Abstract

Background/objectives: The aim of this study was to evaluate the long-term outcomes of a cohort of ophthalmologically resolved female idiopathic intracranial hypertension (IIH) patients. Methods: Our cross-sectional study included adult females with at least 6 months of ophthalmologically resolved IIH. Patients with papilledema or who underwent IIH-targeted surgical intervention were excluded. Participants completed a questionnaire consisting of medical information, the Migraine Disability Assessment Scale (MIDAS) and the Headache Impact Test (HIT-6). Electronic medical records and the results of imaging upon diagnosis were retrospectively reviewed. Results: One-hundred-and-four participants (mean age 35.5 ± 11.9 years) were included (7.85 ± 7 years post-IIH diagnosis). Patients with moderate–severe disability according to the MIDAS scale (n = 68, 65.4%) were younger (32.4 ± 8.9 vs. 41.5 ± 14.4 year-old, p < 0.001), had a shorter time interval from IIH diagnosis (5.9 ± 5.3 vs. 11.7 ± 8.5 years, p < 0.001), and had lower FARB scores (indicating a more narrowed transverse-sigmoid junction; 1.28 ± 1.82 vs. 2.47 ± 2.3, p = 0.02) in comparison to patients with low–mild disability scores. In multivariate analysis, a lower FARB score (OR 1.28, 95% CI 0.89–1.75, p = 0.12) and younger age (OR 1.09, 95% CI 0.98–1.19, p = 0.13) showed a trend toward an association with a moderate–severe MIDAS score. Moreover, in the sub-analysis of patients with a moderate–severe MIDAS scale score, the 10 patients with the highest MIDAS scores had a low FARB score (1.6 ± 1.1 vs. 2.7 ± 2.4, p = 0.041). Conclusions: High numbers of patients with ophthalmologically resolved IIH continue to suffer from related symptoms. Symptoms may be associated with the length of time from the diagnosis of IIH and a lower FARB score.

Publisher

MDPI AG

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