title: Sleep apnea and intracranial hypertension in men.
abstract: 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.
authors.affiliation: Department of Ophthalmology, The University of Iowa Hospitals and Clinics, 200 Hawkins Drive PFP, Iowa City, IA 52242, USA.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Lee
authors.forename: Karl
authors.initials: K
authors.lastname: Golnik
authors.forename: Randy
authors.initials: R
authors.lastname: Kardon
authors.forename: Michael
authors.initials: M
authors.lastname: Wall
authors.forename: Eric
authors.initials: E
authors.lastname: Eggenberger
authors.forename: Sunita
authors.initials: S
authors.lastname: Yedavally
mesh_terms: 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
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D000086:Acetazolamide