Anemia linked to severity of idiopathic intracranial hypertension: A call for Routine screening

Canada: A groundbreaking prospective study revealed that it is paramount for healthcare professionals to consider routine anemia screening for all patients under suspicion of idiopathic intracranial hypertension as about one in five IIH patients experienced anemia. 

The study results were published in the Canadian Journal of Ophthalmology on August 17, 2023. 

Anemia, a condition characterized by a deficiency of red blood cells, has long been associated with idiopathic intracranial hypertension (IIH). However, due to the lack of prospective studies and the shared occurrence of IIH and anemia in young women with obesity, the exact nature of this connection remained elusive. Hence, Canadian researchers conducted a prospective study from 3 neuro-ophthalmology centers between March 2021 and September 2022 on consecutive patients with IIH. 

Patients with IIH were advised a complete blood count available within 6 months of presentation. Anemia was defined as mild (110–120 g/L), moderate (80–109 g/L), and severe (<80 g/L). About 143 patients participated in the study, out of which 113 had normal hemoglobin (group 1) and 30 had anemia (group 2). 

Study results: 

• Anemia in group 2 varied in severity, with 50.0% classified as mild, 36.7% as moderate, and 13.3% as severe.
• Strikingly, there were no discernible differences between the two groups in terms of gender, age, or body mass index. 
• Furthermore, no significant distinctions were found in visual acuity, retinal nerve fiber layer thickness, mean deviation, or the need for medical or surgical interventions in groups 1 and 2. 
• Patients with moderate to severe anemia in group 2 were found to be more likely to require surgical therapy.

This study underscores the importance of early detection and management of anemia in IIH patients, especially when anemia reaches moderate to severe levels. This study not only advances our understanding of IIH but also highlights the need for a proactive approach to managing this condition. Screening for anemia can now be seen as a vital tool in the arsenal against idiopathic intracranial hypertension, ensuring that patients receive the most appropriate and timely care. 

Further reading: Anemia and idiopathic intracranial hypertension: a prospective study. https://doi.org/10.1016/j.jcjo.2023.07.018