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ObjectiveCase description of recurrent idiopathic intracranial hypertension (IIH) in a transgender man on gender-affirming hormone therapy.MethodsCase report.ResultsA 24-year-old transmasculine patient (assigned female at birth), with a body mass index (BMI) of 37.3, presented with headaches, transient visual obscurations (TVOs), pulsatile tinnitus, Frisén 5 papilledema, and scotomas. He was diagnosed with IIH after normal magnetic resonance imaging (MRI) and magnetic resonance venogram (MRV), an elevated opening pressure of 27 cm water, and normal cerebrospinal fluid studies. IIH resolved with acetazolamide and optic nerve sheath fenestration (ONSF). He then started gender-affirming testosterone therapy and was on this for 20 months when his headaches, pulsatile tinnitus, TVOs, and Frisén 3 papilledema recurred at a BMI of 31. Brain MRI and MRV were normal. Opening pressure was elevated at 31 cm. water. Acetazolamide 4 g/day did not improve the papilledema, thus a left ONSF was repeated resulting in eventual resolution of the IIH.DiscussionSeveral reports have been published of IIH development in patients receiving testosterone therapy. Hormone prescribers for gender affirmation may wish to screen for visual loss and optic nerve edema in patients undergoing testosterone therapy, which may also stimulate appetite weight gain.

Held at the Convention Center, after showing vaccination status at registration, there was something for everyone in neurology-and especially neuro-ophthalmology. North American Neuro-Ophthalmology Society (NANOS) members were giving courses, speaking at specialized session, and participating in many events.