Three neuro-ophthalmologists at the John A. Moran Eye Center, University of Utah, participated in a recent NIH-funded study that revealed the use of an inexpensive glaucoma drug (acetazolamide), when added to a weight reduction plan, can improve and even restore vision for women with a disorder called idiopathic intracranial hypertension (IIH). This important discovery was published on April 22, 2014 in the Journal of the American Medical Association.
Moran neuro-ophthalmologists Drs. Kathleen Digre, Judith Warner and Brad Katz were principal investigators for this study called “Effect of Acetazolamide on Visual Function in Patients with Idiopathic Intracranial Hypertension and Mild Visual Loss: The Idiopathic Intracranial Hypertension Treatment Trial.” Also called pseudotumor cerebri, IIH predominately affects overweight women of reproductive age. An estimated 100,000 Americans suffer from IIH. Symptoms include headaches, blind spots, double vision and temporary episodes of blindness.
IIH is named for an increased pressure within the fluid-filled spaces inside and around the brain. This in turn can cause swelling and damage to the optic nerves that connect the eyes to the brain. In severe cases, surgical procedures may be used to relieve pressure on the optic nerve.
Moran Emeritus Professor, Dr. Julia Kleinschmidt, PhD, LCSW, founder of the pioneering Patient Support Program at Moran, said this about the study:“Having met individually and in group meetings with hundreds of women suffering from IIH for more than 20 years, I can’t begin to describe the suffering this discovery will relieve.” Lisa Ord, PhD, LCSW, current director of the program said, “At our IIH group support meeting in October, patients shared many devastating ways this disease had affected them. This pioneering work will allow countless individuals to return to work or school, reduce their medical expenses, and carry out simple tasks of daily living that had been taken away by this disease.”
There are currently no established treatment guidelines for IIH, and approximately 5-10 percent of those affected by the disorder experience permanent vision loss. “This study will be an important resource for medical professionals who treat patients with IIH, especially as it validates the use of acetazolamide. Professionals have speculated this drug might be a viable treatment for the disorder, and now we have validated evidence of its effectiveness,” said Dr. Digre.
The trial involved 161 women and four men with IIH and mild vision loss who were enrolled at 38 sites. All participants were put on a weight-loss plan to trim salt and about 500 to 1,000 calories from their food intake each day. About half the participants were randomly assigned to receive acetazolamide. Participants on acetazolamide improved by about twice as much as those on placebo. The trial will follow participants for five years to gauge whether they’re able to maintain a healthy weight and control their symptoms over the long term.
“The Moran Eye Center has a history of participating in the nation’s leading research surrounding eye-related disorders and diseases, and this study underscores the fine work our team is involved in,” said Dr. Randall J Olson, CEO of the Moran Eye Center. “Drs. Digre, Warner and Katz are known for their work in headache research and championing women’s health issues, so it is especially fitting that this team contributed to research that will go a long way in supporting women with IIH across the country.”
The trial is funded by cooperative agreements from NEI (EY017281 and EY017387).
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