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Michael Wall, Mark J Kupersmith, Elizabeth-Ann Moss, Peggy Auinger; The Idiopathic Intracranial Hypertension Treatment Trial: Outcomes from Months 6 - 12. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether the beneficial effects of acetazolamide (ACZ) in improving vision continues from months 6 to 12 in participants of the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT)
In the IIHTT, after 6 months of a weight management program and either placebo or maximally tolerated ACZ, subjects transitioned from study drug to ACZ unless their papilledema had resolved. The main outcome was the change in mean deviation (MD) from Month 6 to Month 12 in the study eye of groups based on treatment at study entry and after 6 mos.: 1) ACZ to ACZ; n = 34, 2) placebo to ACZ; n = 35, 3) ACZ to no treatment; n = 20, and 4) placebo to no treatment; n = 12. No treatment with ACZ was given if papilledema had resolved.
The placebo subjects in group 4 with no ACZ treatment improved 0.86 dB MD units at 12 mos, p = 0.04. The other three groups improved 0.35 to 0.41 dB MD. Mean improvements in papilledema grade also occurred in all groups but most markedly in the group that exchanged placebo for ACZ (0.94 Frisén grade units, p < 0.001). Quality of life scores and headache disability, also improved with the largest and significant improvement in the group that transitioned from placebo to ACZ. Significant weight change occurred in those transitioning from placebo to ACZ who lost about 6 pounds (p = 0.02) while those tapered off ACZ gained about 6 pounds (p = 0.03).
Clinical improvements in MD continued from month 6 to month 12 of the IIHTT in all treatment groups. This effect was most marked and significant in the placebo group with no papilledema tapered off study drug. Significantly beneficial effects of ACZ on papilledema grade and QoL increased from month 6 to 12. Adding ACZ to the placebo group subjects significantly improved their quality of life measures.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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