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Neuro-Ophthalmology
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For intracranial hypertension

New findings with an old drug

For patients with idiopathic intracranial hypertension (IIH), national study findings have shown that an inexpensive drug, acetazolamide, when combined with a weight loss plan, improves vision for patients who have mild visual loss.

The trial was funded by the National Eye Institute and was conducted at the Emory Eye Center and 27 other sites across the country. The study sought to assist with the management of IIH, also known as pseudomotor cerebri, which causes increased pressure around the brain.

IIH predominantly affects women of reproductive age who are overweight. It is estimated that some 100,000 Americans have it, with the number rising as the proportion of the population who is overweight grows. Symptoms include headaches and visual problems, including enlarged blind spots, poor side (peripheral) vision, double vision, and temporary episodes of blindness. Some 5% to 10% of women with IIH experience disabling vision loss.

“The study provides the necessary evidence that acetazolamide, which neuro-ophthalmologists have used off-label for years, is indeed a beneficial part of our treatment plans for IIH.”
–Neuro-ophthalmologist Bruce Bruce, principal investigator for the trial at the Emory Eye Center.
IIH’s high pressure around the brain can lead to swelling and damage of the nerves that connect the eye to the brain. A weight reduction of 5% to 10% can help improve symptoms. The drug acetazolamide is known to reduce fluid production in the brain and is often used as an add-on therapy for IIH. In severe cases, surgical procedures may be used to relieve pressure on the optic nerve.

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