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Doxycycline and intracranial hypertension

D. I. Friedman, MD, L. K. Gordon, MD PhD, R. A. Egan, MD, D. M. Jacobson, MD, H. Pomeranz, MD PhD, A. R. Harrison, MD and Y. Goldhammer, MD

From the Departments of Ophthalmology and Neurology (Dr. Friedman), University of Rochester School of Medicine and Dentistry, NY, Jules Stein Eye Institute (Dr. Gordon), David Geffen School of Medicine, University of California at Los Angeles, and Greater Los Angeles Veterans Administration Healthcare System, Casey Eye Institute (Dr. Egan), Departments of Ophthalmology and Neurology, Oregon Health and Science University, Portland, Department of Neurology (Dr. Jacobson), Marshfield Clinic, WI, Department of Ophthalmology (Drs. Pomeranz and Harrison), University of Minnesota, Minneapolis; and Department of Neurology (Dr. Goldhammer), Sheba Medical Center, Tel-Hashomer, Israel.

Address correspondence and reprint requests to Dr. D.I. Friedman, Department of Ophthalmology, University of Rochester, 601 Elmwood Ave., Box 659, Rochester, NY 14642; e-mail: Deborah_Friedman{at}urmc.rochester.edu

The authors report seven patients from six neuro-ophthalmology referral centers who developed pseudo-tumor cerebri during treatment with doxycycline. All four female patients and one of three male patients were obese. Vision was minimally affected in most patients, but two had substantial visual acuity or visual field loss at presentation. Discontinuation of doxycycline, with or without additional intracranial pressure-lowering agents, yielded improvement, but permanent visual acuity or visual field loss occurred in five patients.

Received October 8, 2003. Accepted in final form February 23, 2004.

Deceased.

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