The Longitudinal Idiopathic Intracranial Hypertension Trial: Outcomes From Months 6-12

Michael Wall; Mark J Kupersmith; Matthew J Thurtell; Heather E Moss; Elizabeth Ann Moss; Peggy Auinger; NORDIC Idiopathic Intracranial Hypertension Study Group

doi:10.1016/j.ajo.2017.01.004

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The Longitudinal Idiopathic Intracranial Hypertension Trial: Outcomes From Months 6-12

Journal article

Open access

Peer reviewed

The Longitudinal Idiopathic Intracranial Hypertension Trial: Outcomes From Months 6-12

Michael Wall, Mark J Kupersmith, Matthew J Thurtell, Heather E Moss, Elizabeth Ann Moss, Peggy Auinger and NORDIC Idiopathic Intracranial Hypertension Study Group

American journal of ophthalmology, Vol.176, pp.102-107

04/2017

DOI: 10.1016/j.ajo.2017.01.004

PMCID: PMC5376520

PMID: 28104417

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Abstract

To determine whether the beneficial effects of acetazolamide (ACZ) in improving vision at 6 months continues to month 12 in participants of the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT). Nonrandomized clinical study. In the IIHTT, subjects were randomly assigned to placebo-plus-diet or maximally tolerated dosage of acetazolamide-plus-diet. At 6 months subjects transitioned from study drug to ACZ. This resulted in the following groups: (1) ACZ to ACZ; n = 34; (2) placebo to ACZ; n = 35; (3) ACZ to no treatment; n = 16; and (4) placebo to no treatment; n = 11. Ninety-six IIHTT subjects had evaluations at 6 and 12 months. Our main outcome measure was change from month 6 to month 12 in visual field mean deviation (MD) with secondary measures being change in papilledema grade, ETDRS scores, and quality-of-life (QoL) measures. The ACZ to ACZ group improved 0.35 dB, P = .05; placebo subjects with no ACZ improved 0.81 dB MD, P = .07 at 12 months. The other groups improved 0.35-0.46 dB MD. Mean improvements in papilledema grade occurred most markedly in the group that exchanged placebo for ACZ (0.91 units, P < .001). QoL and headache disability scores showed significant improvements in the placebo group with added ACZ. Improvements in MD continued from month 6 to month 12 of the IIHTT in all treatment groups, most marked in the placebo group tapered off study drug. Adding ACZ to the placebo group significantly improved papilledema grade, headache, and QoL measures.

Quality of Life

Pseudotumor Cerebri - drug therapy

Visual Fields - physiology

Follow-Up Studies

Administration, Oral

Humans

Carbonic Anhydrase Inhibitors - administration & dosage

Male

Treatment Outcome

Acetazolamide - administration & dosage

Pseudotumor Cerebri - physiopathology

Dose-Response Relationship, Drug

Papilledema - physiopathology

Papilledema - prevention & control

Time Factors

Pseudotumor Cerebri - complications

Adult

Female

Papilledema - etiology

Details

Title: Subtitle: The Longitudinal Idiopathic Intracranial Hypertension Trial: Outcomes From Months 6-12
Creators: Michael Wall - Department of Neurology, University of Iowa, Iowa City, Iowa; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa. Electronic address: michael-wall@uiowa.edu
Mark J Kupersmith - Mount Sinai West and New York Eye and Ear Infirmary, New York, New York
Matthew J Thurtell - Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
Heather E Moss - Illinois Eye and Ear Infirmary, Chicago, Illinois
Elizabeth Ann Moss - Mount Sinai West and New York Eye and Ear Infirmary, New York, New York
Peggy Auinger - Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
NORDIC Idiopathic Intracranial Hypertension Study Group
Resource Type: Journal article
Publication Details: American journal of ophthalmology, Vol.176, pp.102-107
DOI: 10.1016/j.ajo.2017.01.004
PMID: 28104417
PMCID: PMC5376520
NLM abbreviation: Am J Ophthalmol
ISSN: 1879-1891
eISSN: 1879-1891
Publisher: Elsevier BV; United States
Grant note: K23 EY024345 / NEI NIH HHS U10 EY017281 / NEI NIH HHS
Language: English
Date published: 04/2017
Academic Unit: Neurology; Ophthalmology and Visual Sciences
Record Identifier: 9983979977702771

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