An Estimation of the Risk of Pseudotumor Cerebri among Users of the Levonorgestrel Intrauterine Device

Reuben M Valenzuela; Ruju Rai; Brian H Kirk; Jessica N Sanders; Subhashree Sundar; Steffen Hamann; Judith E A Warner; Kathleen B Digre; Alison V Crum; Kirtly P Jones; Bradley J Katz

doi:10.1080/01658107.2017.1304425

An Estimation of the Risk of Pseudotumor Cerebri among Users of the Levonorgestrel Intrauterine Device

Neuroophthalmology. 2017 Apr 19;41(4):192-197. doi: 10.1080/01658107.2017.1304425. eCollection 2017 Aug.

Authors

Reuben M Valenzuela^{1

2}, Ruju Rai¹, Brian H Kirk¹, Jessica N Sanders³, Subhashree Sundar⁴, Steffen Hamann⁵, Judith E A Warner^{1

2}, Kathleen B Digre^{1

2}, Alison V Crum^{1

2}, Kirtly P Jones³, Bradley J Katz^{1

2}

Affiliations

¹ Department of Ophthalmology and Visual Sciences; John A. Moran Eye Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
² Department of Neurology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
³ Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
⁴ Department of Operations and Information Systems, David Eccles School of Business, University of Utah, Salt Lake City, Utah, USA.
⁵ Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark.

Abstract

Because of a previous association of pseudotumor cerebri (PTC) with levonorgestrel, we wished to evaluate the use of levonorgestrel-eluting intrauterine devices ("levonorgestrel intrauterine systems", LNG-IUS) in our University of Utah and Rigshospitalet PTC patients. In our retrospective series, PTC prevalence was approximately 0.18% and 0.15% in the LNG-IUS population versus 0.02% and 0.04% in the non-LNG-IUS population (Utah and Rigshospitalet, respectively), with no significant differences in PTC signs and symptoms among the two groups. Our investigation suggests that women with an LNG-IUS may have increased risk of developing PTC but does not suggest an LNG-IUS can cause PTC.

Keywords: Contraception; idiopathic intracranial hypertension; intrauterine system; levonorgestrel; pseudotumor cerebri.

Grants and funding

This study was supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York, USA, to the Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah, USA.