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The relationship between obesity and idiopathic intracranial hypertension

Abstract

OBJECTIVES: To evaluate the association between obesity and idiopathic intracranial hypertension (IIH) and establish whether there is a relationship with visual outcome. To calculate the prevalence and degree of obesity in a group of patients with IIH.

METHODS: 34 patients (31 female and 3 male) were recruited between 1993–1997 with a diagnosis of IIH. Assessment included visual acuity, visual field assessment (Humphrey automated and Goldmann manual perimetry), fundus assessment and measurement of body mass index (BMI). Obesity was defined as a BMI of ≥30 kg/m2.

RESULTS: 70.5% of patients were obese. The relative risk for obesity and IIH was significant at 8 (95%CI: 2,29). This increased to 17 (95%CI: 5,62) for obese females aged 16 to 24 years and 10 (95%CI: 3,35.5) for obese females aged 25 to 34 years. Morbid obesity (BMI>40) was significantly associated with poor visual outcome. Serial obesity measures showed generally little change in weight over time and there was no correlation between weight change and visual improvement.

CONCLUSIONS: This study has documented a relationship between obesity and IIH. A high degree of obesity was associated with a poor visual function and identified as a risk factor for poor outcome. Obesity may be an aetiological factor in this condition although it is unlikely to be the sole cause but more probably a precipitating factor. Weight loss is recommended although failure to lose weight is common. Any weight reduction programme must therefore be actively encouraged and monitored.

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Rowe, F., Sarkies, N. The relationship between obesity and idiopathic intracranial hypertension. Int J Obes 23, 54–59 (1999). https://doi.org/10.1038/sj.ijo.0800758

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