Diamox Sharpened Vision in IIH Patients

Acetazolamide improved vision field in idiopathic intracranial hypertension patients with mild vision loss

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Losing your vision is a frightening prospect and a very real threat for people with idiopathic intracranial hypertension (IIH). One medication may help these patients.

A recent study found that acetazolamide (Diamox) with a low-sodium weight reduction diet provided a modest improvement to the vision of IIH patients compared to patients receiving only the low-sodium diet.

Patients with IIH have increased pressure around the brain, which can cause severe headaches, nausea and vision difficulties.

"See your optometrist regularly for an eye exam."

This study was led by Michael Wall, MD, professor of neurology at the University of Iowa Hospitals and Clinics.

The research team worked with 165 participants who were diagnosed with IIH accompanied with mild vision loss. These participants were enrolled at 38 academic and private medical practices in North America, with half of the participants receiving acetazolamide along with a low-sodium diet and the rest receiving a placebo (mock medication) along with their low-sodium diet.

The participants' vision was tested over six months using the eye that was affected most by IIH, as measured using a Humphrey Field Analyzer to determine perimetric mean deviation (PMD) or the amount of vision field loss.

The patients' PMD at the beginning of the study ranged from 2 to -32 dB, with larger numbers indicating a greater loss of vision.

The research team found that participants who received acetazolamide showed an improvement of 1.43 dB in PMD compared to the placebo group, which showed a PMD improvement of 0.71 dB.

The authors noted that the acetazolamide group had more adverse events, such as tingling skin, fatigue, nausea and tinnitus.

The authors concluded that for patients with IIH and mild vision loss, the use of acetazolamide along with a low-sodium weight loss diet showed modest improvement in the patients' field of vision compared to diet alone.

The authors acknowledged that this study was limited by the high participant withdrawal rate, which was similar in each group, and may have been caused by the intense visit schedule required.

This study was published April 22 in JAMA.

The research was funded by grants from the National Eye Institute.

Several of the study's authors disclosed receiving fees and grants from Teva, Impax, Bristol-Myers Squibb and other pharmaceutical companies.

Review Date: 
April 21, 2014
Last Updated:
April 23, 2014