Faculty of Medicine (IS), University of Toronto, Toronto, Canada; Division of Ophthalmology (CWY), Department of Surgery, McMaster University, Hamilton, Canada; Department of Ophthalmology and Vision Sciences (EM, JAM), University of Toronto, Toronto, Canada; and Kensington Vision and Research Centre (JAM), Toronto, Canada.
J Neuroophthalmol. 2023 Dec 1;43(4):535-540. doi: 10.1097/WNO.0000000000001715. Epub 2022 Oct 18.
Idiopathic intracranial hypertension (IIH) is a condition of elevated intracranial pressure without an identifiable cause. It mostly affects young obese women but has been reported in individuals newly diagnosed with anemia or with chronic anemia. The relationship between anemia and IIH is not well elucidated. This study aims to characterize the course of IIH in anemic patients.
Consecutive patients with IIH were recruited from neuro-ophthalmology clinics. Subsequent retrospective chart review obtained information on symptoms, complete blood counts (CBCs), visual acuity, visual fields, and optic disc edema at baseline and follow-up. Anemia was diagnosed by hemoglobin <120 g/L (women) and <130 g/L (men).
One hundred twenty-three patients with IIH were recruited for this study, and 22.8% (28/123) had anemia. More anemic individuals had mild-to-moderate visual acuity impairment (logarithm of minimum angle of resolution 0.3-1, P = 0.01) and worse automated mean deviation ( P = 0.048). The median follow-up time was 47.4 weeks (interquartile range:20.1-91.8). Fifteen of 28 patients with anemia received anemia treatment and showed a trend toward increased hemoglobin. At follow-up, there were no differences in the visual acuity, but patients with anemia had worse automated mean deviation on visual fields ( P = 0.045).
IIH patients with anemia had worse visual function at presentation and worse final visual field parameters. This suggests that CBCs should be obtained for patients with papilledema because it may influence final visual outcome.
特发性颅内高压（IIH）是一种颅内压升高但没有明确病因的疾病。它主要影响年轻肥胖女性，但也有新诊断为贫血或慢性贫血的个体报告。贫血与 IIH 之间的关系尚未得到很好的阐明。本研究旨在描述贫血患者 IIH 的病程。
连续从神经眼科诊所招募 IIH 患者。随后回顾病历，获取基线和随访时的症状、全血细胞计数（CBC）、视力、视野和视盘水肿信息。贫血的诊断标准为女性血红蛋白<120 g/L 和男性血红蛋白<130 g/L。
本研究共招募了 123 例 IIH 患者，其中 22.8%（28/123）有贫血。更多贫血患者有轻度至中度视力障碍（最小分辨角对数 0.3-1，P=0.01）和更差的自动平均偏差（P=0.048）。中位随访时间为 47.4 周（四分位距：20.1-91.8）。28 例贫血患者中有 15 例接受了贫血治疗，血红蛋白呈上升趋势。随访时，视力无差异，但贫血患者的视野自动平均偏差更差（P=0.045）。
有贫血的 IIH 患者在就诊时视力功能更差，最终视野参数也更差。这表明，对于有视盘水肿的患者应进行 CBC 检查，因为它可能会影响最终的视力预后。
