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New research · Ophthalmology
Cureus · 12h
Case reportCureus · 2026

Idiopathic Intracranial Hypertension Without Papilledema in a Transgender Woman With HIV: A Case Report and Review of Risk Factors.

Susana P Garcia, Peter Hsin, Shon Shmushkevich … Lorena Bonilla
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OphthalmologyCase report

Transgender woman with HIV had vision loss from elevated pressure but no papilledema

Idiopathic Intracranial Hypertension Without Papilledema in a Transgender Woman With HIV: A Case Report and Review of Risk Factors.

Susana P Garcia … Lorena Bonilla
Cureus · 2026
Background

Idiopathic intracranial hypertension (intracranial hypertension) is a disorder characterized by elevated intracranial pressure (intracranial pressure) in the absence of intracranial mass lesions, hydrocephalus, or infection.

Methods

A 34-year-old transgender woman with well-controlled HIV, assigned male at birth, presented with six months of progressive bilateral peripheral visual field loss accompanied by chronic headache, nausea, dizziness, and diplopia.

53
Results
53
cm H₂O
spinal fluid pressure was markedly elevated, well above normal
More results

Established risk factors include obesity, female sex, and hormonal influences, while intracranial hypertension in people living with HIV remains uncommon.

Neurologic examination revealed severe visual field constriction without papilledema.

Infectious, inflammatory, and neoplastic etiologies were excluded.

More results

The patient was diagnosed with intracranial hypertension without papilledema and treated with acetazolamide, with plans for close neuro-ophthalmologic follow-up.

“
Conclusion

The potential contributions of antiretroviral therapy, estrogen use, obesity, and psychosocial stressors warrant further investigation.

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