Socioeconomic and Geographic Disparities in Idiopathic Intracranial Hypertension.

OBJECTIVE: To identify relationships between idiopathic intracranial hypertension (IIH) and socioeconomic determinants of health, such as low-income status and proximity to healthy food. METHODS: This retrospective case-control study of adult female neuro-ophthalmology patients from one institution identified 223 women with and 4,783 women without IIH. Street addresses were geocoded and merged with US census data to obtain census tract-level information on income and food access. Choropleth maps visualized IIH clusters within certain neighborhoods. Logistic regression compared the proportion of patients with IIH from racial and ethnic minority backgrounds, low-income census tracts, and food deserts and swamps to controls without IIH. RESULTS: In our cohort, when adjusted for age, women with IIH were more likely to be Black (odds ratio [OR] 3.96, 95% confidence interval [CI] 2.98-5.25), Hispanic (OR 2.23, 95% CI 1.14-4.36), and live in low-income tracts (OR 2.24, 95% CI 1.71-2.95) or food swamps (OR 1.54, 95% CI 1.15-2.07). Patients with IIH were less likely to live in food deserts than controls (OR 0.61, 95% CI 0.45-0.83). The association between Black race and IIH remained significant even after adjusting for other variables. CONCLUSION: IIH is more common among Black and Hispanic women than expected even when accounting for the demographics of a metropolitan city. Some of this relationship is driven by the association of obesity and IIH incidence with low income and proximity to unhealthy foods.

Idiopathic intracranial hypertension: clinical features in Chinese patients.

PURPOSE: To describe the clinical features and visual outcomes of idiopathic intracranial hypertension (IIH) in Chinese patients. METHODS: We retrospectively reviewed the charts of patients diagnosed with IIH in Taipei Veterans General Hospital from 1981 to 2009. Demographic data, clinical features, laboratory data, treatment, and visual outcomes were analyzed. RESULTS: Twelve patients were included, seven female and five male patients. The mean age at onset was 32 (range, 13-65) years. Obesity was found in four (33%) patients. The most common clinical symptom was headache (75%), followed by transient visual obscuration (42%) and tinnitus (17%). Snellen visual acuity was equal to or better than 20/30 in 23 eyes, and the only eye with vision worse than 20/50 vision belonged to a patient who had been amblyopic since childhood. Visual field defects were detected in seven eyes by either Goldmann or automated perimetry. Generalized depression and an enlarged blind spot were the most common patterns. Ten patients were found to have bilateral disc edema. One patient with unilateral papilledema and one patient without papilledema were identified in the study. CONCLUSIONS: In IIH in Chinese, men are more likely to be affected than women, but obesity is not as frequent as reported in Western countries. Visual function outcomes are more favorable in Chinese patients.