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Neuro-Ophthalmic Literature Review

Kilgore KP, Lee MS, Leavitt JA, Frank RD, McClelland CM, Chen JJ. A Population-Based, Case-Control Evaluation of the Association Between Hormonal Contraceptives and Idiopathic Intracranial Hypertension. American journal of ophthalmology. 2019 Jan 1;197:74-9. This retrospective study addresses the long-held suspicion that there may be a link between the use of hormonal contraceptives and idiopathic intracranial hypertension (IIH). The authors reviewed the charts of 53 patients who were diagnosed with IIH based on the modified Dandy criteria and a lumbar puncture opening pressure >250 mmH20. They found that 20.8% of these women were using hormonal contraception as compared to 30.3% in the control group. The most common form of contraception was an oral contraceptive pill (15.1%). The authors found that the use of hormonal contraceptives, either in the form of oral pills or non-oral methods, was not associated with an increased risk of IIH. Despite some of the limitations in this study, including the retrospective design and the lack of data regarding other medications that are known to contribute to IIH, the authors have contributed important evidence in the debate as to whether the use of hormonal contraceptives is a contributing/ causative factor in idiopathic intracranial hypertension. David Bellows