Comparison of clinical profiles of idiopathic intracranial hypertension in patients with and without anemia

PURPOSE: To compare the demographic, clinical, visual, and structural parameters in idiopathic intracranial hypertension (IIH) patients with and without anemia. METHODS: This was a prospective comparative clinical study conducted at a tertiary eye care center. Patients fulfilling the modified Dandy criteria for IIH were enrolled. Demographic details, systemic associations, and body mass index (BMI) were recorded. Hemoglobin levels were assessed in all patients, who were then categorized as either anemic or nonanemic. All patients underwent comprehensive ophthalmic evaluation, including visual acuity, papilledema grading, visual fields, and retinal nerve fiber layer thickness. Cerebrospinal fluid opening pressure was also recorded. RESULTS: Of 92 patients, 42 were anemic, and 50 were nonanemic. Age was comparable between anemic and nonanemic groups (28.2 ± 9.0 vs. 30.4 ± 7.9 years; P = 0.218), and BMI distribution did not differ significantly (P = 0.255). Female predominance was higher in anemics (100% vs. 86%; P = 0.012). Visual acuity (0 [IQR 0-0.24] vs. 0 [IQR 0-0.30]; P = 0.895), mean deviation (-2.27 [IQR -4.5 to -1] vs. -2.51 [IQR -5 to -1] dB; P = 0.844), RNFL thickness (215 [IQR 138-310] vs. 165 [IQR 119-283] µm; P = 0.212), and CSF OP (27 [IQR 26-35] vs. 30 [IQR 26-36] cm H₂O; P = 0.366) showed no statistically significant or clinically meaningful differences. CONCLUSION: Although anemia and obesity represented distinct triggers, both groups demonstrated comparable structural and functional profiles after IIH developed.