Journal article
The Effect of Acetazolamide and Weight Loss on Intraocular Pressure in Idiopathic Intracranial Hypertension Patients
Journal of glaucoma, Vol.28(4), pp.352-356
04/2019
DOI: 10.1097/IJG.0000000000001189
PMID: 30624392
Abstract
Acetazolamide (ACZ) lowers intraocular pressure (IOP), acutely in normal eyes and both acutely and chronically in eyes with glaucoma, and cerebrospinal fluid pressure (CSFp), chronically in patients with idiopathic intracranial hypertension (IIH). We hypothesize chronic daily ACZ would significantly reduce IOP and contribute to a translaminar pressure gradient change reflected by alteration in the CSFp-IOP difference and the deformation of the neural canal in patients with IIH and no glaucoma.
Before randomization to ACZ or placebo treatment for 6 months, 165 participants in the IIH Treatment Trial had evaluations that included Goldmann applanation, CSFp measurement, and optical coherence tomography determination of the neural canal deformation. These measures were repeated at the 6-month outcome.
The IOP was not significantly decreased from baseline at 1, 3, or 6 months in eyes in both treatment groups. At month 6, the amount of ACZ or weight modification did not correlate with any IOP change. The 6-month mean change in neural canal deformation was 0.96 and -0.04 (P=0.001) and in CSFp was -128 and -38 mm H2O (P=0.001), but CSFp-IOP difference change was not significant, in the ACZ and placebo groups, respectively.
ACZ does not reduce the IOP in eyes without glaucoma but does decrease the pathologic elevated CSFp, providing evidence that normal systems can compensate for chronic medication effects. The CSFp-IOP is not a direct marker of translaminar pressure gradient and the ACZ normalization of the neural canal deformation appears due to CSFp reduction alone.
Details
- Title: Subtitle
- The Effect of Acetazolamide and Weight Loss on Intraocular Pressure in Idiopathic Intracranial Hypertension Patients
- Creators
- Rudrani Banik - Icahn School of Medicine at Mount SinaiMark J Kupersmith - Icahn School of Medicine at Mount SinaiJui-Kai Wang - Iowa City VA Health Care SystemMona K Garvin - University of IowaNORDIC Idiopathic Intracranial Hypertension Study Group
- Resource Type
- Journal article
- Publication Details
- Journal of glaucoma, Vol.28(4), pp.352-356
- DOI
- 10.1097/IJG.0000000000001189
- PMID
- 30624392
- ISSN
- 1057-0829
- eISSN
- 1536-481X
- Grant note
- U10 EY017387 / NEI NIH HHS R01 EY023279 / NEI NIH HHS U10 EY017281 / NEI NIH HHS
- Language
- English
- Date published
- 04/2019
- Academic Unit
- Electrical and Computer Engineering; Ophthalmology and Visual Sciences
- Record Identifier
- 9984197916902771
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