Medication helps improve vision for patients with neurological disorder

April 22, 2014

In patients with idiopathic intracranial hypertension and mild vision loss, the use of the drug acetazolamide, along with a low-sodium weight-reduction diet, resulted in modest improvement in vision, compared with diet alone, according to a study in the April 23/30 issue of JAMA, a neurology theme issue.

Idiopathic intracranial hypertension (IIH) is a disorder primarily of overweight women of childbearing age, characterized by increased intracranial pressure with its associated signs and symptoms, including debilitating headaches and vision loss. Acetazolamide is commonly used to treat this condition, but strong evidence to support its use is lacking, according to background information in the article.

Michael Wall, M.D., of the University of Iowa, Iowa City, and colleagues with the NORDIC Idiopathic Intracranial Hypertension Study Group Writing Committee, randomly assigned 165 participants with IIH and mild visual loss to receive or matching placebo for 6 months to determine its effect on reducing or reversing visual loss. All participants were also asked to follow a low-sodium weight-reduction diet.

The average improvement in perimetric mean deviation (PMD; a measure of global visual field loss) was greater with acetazolamide than with placebo. In addition, there were improvements in papilledema (optic disc swelling) and vision-related quality of life with acetazolamide. Participants who received acetazolamide also experienced a greater reduction in weight.

There were few unexpected adverse events associated with acetazolamide use.

"This is the first multicenter, double-blind, randomized, controlled clinical trial, to our knowledge, to show that acetazolamide improves visual outcome in IIH," the authors write. "The clinical importance of this improvement remains to be determined."

"The obesity epidemic has increased the prevalence of pseudotumor cerebri [idiopathic intracranial hypertension]. Consequently, the health care costs associated with the treatment of this disease have escalated sharply," writes Jonathan C. Horton, M.D., Ph.D., of the University of California, San Francisco, in an accompanying editorial.

"The NORDIC trial has provided solid evidence that patients can be treated effectively by weight loss and acetazolamide. Their visual acuity and visual fields should be tested regularly, at a frequency that depends on the severity of their condition. If vision is failing despite medical treatment, rapid surgical intervention is necessary."

"Additional studies are needed to refine the management of patients with pseudotumor cerebri to ensure preservation of visual function."

Explore further: Researcher tests drug's impact on neurological disease affecting women

More information: DOI: 10.1001/jama.2014.3312
DOI: 10.1001/jama.2014.3325

Related Stories

Training can improve visual field losses from glaucoma

April 17, 2014

(HealthDay)—Visual field loss from glaucoma is in part reversible by behavioral, computer-based, online controlled vision training, according to a study published in the April issue of JAMA Ophthalmology.

Recommended for you

New insights on how cocaine changes the brain

November 25, 2015

The burst of energy and hyperactivity that comes with a cocaine high is a rather accurate reflection of what's going on in the brain of its users, finds a study published November 25 in Cell Reports. Through experiments conducted ...

Can physical exercise enhance long-term memory?

November 25, 2015

Exercise can enhance the development of new brain cells in the adult brain, a process called adult neurogenesis. These newborn brain cells play an important role in learning and memory. A new study has determined that mice ...

Umbilical cells help eye's neurons connect

November 24, 2015

Cells isolated from human umbilical cord tissue have been shown to produce molecules that help retinal neurons from the eyes of rats grow, connect and survive, according to Duke University researchers working with Janssen ...

Brain connections predict how well you can pay attention

November 24, 2015

During a 1959 television appearance, Jack Kerouac was asked how long it took him to write his novel On The Road. His response – three weeks – amazed the interviewer and ignited an enduring myth that the book was composed ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.