Sleep apnea and intracranial hypertension in men.
OBJECTIVE
To investigate sleep apnea as an associated finding in idiopathic intracranial hypertension (IIH) in men.


METHODS
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.
Lee
Andrew G
AG
Department of Ophthalmology, The University of Iowa Hospitals and Clinics, 200 Hawkins Drive PFP, Iowa City, IA 52242, USA.
Golnik
Karl
K
Kardon
Randy
R
Wall
Michael
M
Eggenberger
Eric
E
Yedavally
Sunita
S
D000086:Acetazolamide / Q000627:therapeutic use; D000328:Adult; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000188:drug therapy; D011175:Positive-Pressure Respiration; D011559:Pseudotumor Cerebri / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014792:Visual Acuity; D014794:Visual Fields
D002257:Carbonic Anhydrase Inhibitors; D000086:Acetazolamide