Corporate Banner
Satellite Banner
Pharma Outsourcing
Scientific Community
Become a Member | Sign in
Home>News>This Article

Glaucoma Drug Helps Women with Blinding Disorder Linked to Obesity

Published: Friday, April 25, 2014
Last Updated: Friday, April 25, 2014
Bookmark and Share
Drug treatment and weight loss can restore lost vision, NIH-funded study shows.

An inexpensive glaucoma drug, when added to a weight loss plan, can improve vision for women with a disorder called idiopathic intracranial hypertension (IIH), according to a study funded by the National Institutes of Health.

IIH, also called pseudotumor cerebri, predominantly affects overweight women of reproductive age. An estimated 100,000 Americans have it, and the number is rising with the obesity epidemic. The most common symptoms are headaches and visual problems, including blind spots, poor side vision, double vision and temporary episodes of blindness. About 5-10 percent of women with IIH experience disabling vision loss.

"Our results show that acetazolamide can help preserve and actually restore vision for women with IIH, when combined with a moderate but comprehensive dietary and lifestyle modification plan," said Michael Wall, M.D., a professor of neurology and ophthalmology at the University of Iowa in Iowa City.

The trial was funded by NIH's National Eye Institute, and coordinated by the Neuro-Ophthalmology Research Disease Investigator Consortium (NORDIC). The results were published in the Journal of the American Medical Association, and will be presented on May 2 during the Clinical Trials plenary session of the American Academy of Neurology meeting in Philadelphia.

Acetazolamide (Diamox) is best known as a glaucoma drug. It has been commonly prescribed for IIH, but without much evidence that it helps. The IIH Treatment Trial tested the benefits of acetazolamide plus a weight loss plan versus the weight loss plan with a placebo pill, over six months. Patients in both treatment groups had improved vision, but those receiving the drug had the greatest improvement. All patients were allowed to take headache medications throughout the trial, and both groups experienced a similar reduction in headache.

"The vision problems associated with this condition can be extremely debilitating, at significant cost to patients and the health care system. Yet there are no established treatment guidelines. We made it a priority to develop an evidence-based treatment for helping patients keep their vision," said Eleanor Schron, Ph.D., director of clinical applications at NEI.

IIH is named for one of its key physical findings - 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. A 5-10 percent weight reduction appears to improve symptoms for many patients, but can be difficult to achieve and maintain. Acetazolamide is known to reduce fluid production in the brain, and is often used as an add-on therapy. In severe cases, surgical procedures may be used to relieve pressure on the optic nerve.

The dosing and results with acetazolamide vary. In high doses, the drug can produce side effects including fatigue, nausea, tingling hands and feet, and a metallic taste, usually triggered by carbonated drinks. British researchers completed a trial of the drug for IIH in 2011, but the results were inconclusive.

The NIH-funded trial involved 161 women and four men with IIH and mild vision loss, who were enrolled at 38 sites. At enrollment, their average body mass index (BMI) was about 40. A BMI of 30 or greater is considered obese. 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, with the goal to lose 6 percent of their starting weight. They were provided with a weight loss coach and some simple low-cost exercise equipment.

This included a step counter and a resistance band, a piece of rubber tubing used for strength training. About half the participants were randomly assigned to receive acetazolamide. The drug was given at 1 gram daily for the first week and increased by a quarter gram each week, to reach the maximally tolerated dosage, or up to 4 grams daily. The other half of participants received a placebo in gradually increasing dosages.

After six months, both groups had improved scores on visual field tests, a measure of side or peripheral vision. Participants on acetazolamide improved by about twice as much as those on placebo. Compared to weight loss alone, the drug also helped reduce swelling of the optic nerve. The drug-weight loss combination also led to greater improvements in daily function and quality of life compared to weight loss alone, based on the NEI Visual Functioning Questionnaire.

In the placebo group, there were six treatment failures - defined as a substantial worsening of vision that required withdrawal from the trial. There was one treatment failure in the acetazolamide group.

Seven people on acetazolamide and one person on placebo stopped taking their assigned study medication because of perceived side effects. Three people on placebo were admitted to the hospital compared to six on the drug, two of whom developed kidney stones. All side effects were reversed by stopping the drug or reducing the dosage.

"This study provides a much-needed evidence base for using acetazolamide as an adjunct to weight loss for treating IIH," said Dr. Wall. "The drug has been around since the 1950s, and prior studies have found varying degrees of efficacy. One strength of our study is that we slowly introduced patients to the highest tolerated dose, in an attempt to maximize efficacy while limiting its side effects."

Another strength of the study was the weight loss program, he said. The New York Obesity Nutrition Research Center designed the program to achieve moderate, sustainable weight control with an emphasis on changing lifestyle, as opposed to just dieting.

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.

Dr. Wall serves as the trial director. NORDIC is chaired by Mark Kupersmith, M.D., who is director of neuro-ophthalmology services at the New York Eye and Ear Infirmary. The NORDIC data coordination and biostatistics center is directed by Karl Kieburtz, M.D., M.P.H., a professor of neurology and community and preventive medicine at the University of Rochester in New York, and by Michael McDermott, Ph.D., a professor of biostatistics and neurology, also at Rochester.

Further Information

Join For Free

Access to this exclusive content is for Technology Networks Premium members only.

Join Technology Networks Premium for free access to:

  • Exclusive articles
  • Presentations from international conferences
  • Over 3,500+ scientific posters on ePosters
  • More than 5,200+ scientific videos on LabTube
  • 35 community eNewsletters

Sign In

Forgotten your details? Click Here
If you are not a member you can join here

*Please note: By logging into you agree to accept the use of cookies. To find out more about the cookies we use and how to delete them, see our privacy policy.

Related Content

Skin Patch to Treat Peanut Allergy
NIH-funded study suggests peanut protein patch is a safe and convenient method of treatment.
Thursday, October 27, 2016
NIH Contributes to Global Effort to Prevent and Manage Lung Diseases
The large scale trial will measure health benefits of clean cookstoves.
Thursday, October 20, 2016
Scientists at NIH and Emory Achieve Sustained SIV Remission in Monkeys
The finding suggest that the immune systems of these animals are controlling SIV replication in the absence of antiretroviral therapy.
Friday, October 14, 2016
Drug to Treat Alcohol Use Disorder Shows Promise Among Drinkers With High Stress
The findings suggest that potential future studies with drugs targeting vasopressin blockade should focus on populations of people with AUD who also report high levels of stress.
Friday, September 30, 2016
Stem Cell Therapy Heals Injured Mouse Brain
A team of researchers has developed a therapeutic technique that dramatically increases the production of nerve cells in mice with stroke-induced brain damage.
Tuesday, August 23, 2016
Zika Vaccine Testing in Humans
The NAAID has initiated a clinical trail of a vaccine candidate for the prevention of the Zika virus infection.
Thursday, August 04, 2016
NIH Begins Yellow Fever Vaccine Trial
NIH has initiated an early-stage clinical trial of a vaccine to protect against yellow fever.
Thursday, July 28, 2016
NIH-Funded Center to Study Inefficiencies in Clinical Trials
Researchers at the Duke Clinical Research Institute (DCRI) and Vanderbilt University Medical Center (VUMC) have received a major federal grant to study how multisite clinical trials of new drugs and therapies in children and adults can be conducted more rapidly and efficiently.
Thursday, July 07, 2016
PREVAIL Treatment Trial for Men with Persistent Ebola Viral RNA
The six-month study will enroll 60 to 120 EVD survivors.
Wednesday, July 06, 2016
Investigational Malaria Vaccine Protects Healthy U.S. Adults
Researchers at NIH have found that the malaria vaccine protected a small number of healthy, malaria-naïve adults in the U.S. from infection for more than one year after immunization.
Tuesday, May 10, 2016
Study Finds Factors That May Influence Influenza Vaccine Effectiveness
Researchers at NIH have suggested that the long-held approach to predicting seasonal influenza vaccine effectiveness may need to be revisited.
Wednesday, April 20, 2016
Submissions Open for the Cancer Moonshot Program
NCI opens online platform to submit ideas about research for Cancer Moonshot.
Tuesday, April 19, 2016
Promising Experimental Dengue Vaccine
A clinical trial in which volunteers were infected with dengue virus six months after receiving either an experimental dengue vaccine or a placebo injection yielded starkly contrasting results.
Thursday, March 17, 2016
Eylea Outperforms Avastin for Diabetic Macular Edema with Moderate or Worse Vision Loss
NIH-funded clinical trial shows Eylea, Avastin, and Lucentis perform similarly when vision loss is mild.
Wednesday, March 02, 2016
Vaginal Ring Provides Partial Protection From HIV In Large Multinational Trial
Study finds protective effect is strongest in women over age 25.
Friday, February 26, 2016
Scientific News
Salford Lung Study - The First Real World Clinical Trial
In this podcast, we learn about the Salford Lung Study and its potential to revolutionize the way we assess new drugs and treatments around the world.
Skin Patch to Treat Peanut Allergy
NIH-funded study suggests peanut protein patch is a safe and convenient method of treatment.
Anti-Inflammatory Drugs Could Help Treat Depression
Anti-inflammatory drugs could be used to treat some cases of depression, which further implicates our immune system in mental health disorders.
NIH Contributes to Global Effort to Prevent and Manage Lung Diseases
The large scale trial will measure health benefits of clean cookstoves.
Questioning the Safety of Selenium to Combat Cancer
Research indicates the need for change in practice as selenium supplements cannot be recommended for preventing colorectal cancer.
Scientists at NIH and Emory Achieve Sustained SIV Remission in Monkeys
The finding suggest that the immune systems of these animals are controlling SIV replication in the absence of antiretroviral therapy.
Painting the Way to Tumour Imaging
Tumour paint used in emergency surgery to aid cell identification for surgeons.
Anti-Cancer Drug Uses Tumour mRNA to Identify Responders
Phase I study of novel anti-cancer drug uses tumour mRNA expression to identify patients who will respond to the drug.
Targeting Estrogen Receptor Improves Survival in Breast Cancer
Trial finds estrogen receptor degrader significantly increases progression-free survival in patients with advanced breast cancer.
Clinical Trial Finds Medicine Program Alters Blood Serum
Meditation, yoga and vegetarian diet linked to decline in plasma metabolites associated with inflammation and cardiovascular disease risk.
Scroll Up
Scroll Down

SELECTBIO Market Reports
Go to LabTube
Go to eposters
Access to the latest scientific news
Exclusive articles
Upload and share your posters on ePosters
Latest presentations and webinars
View a library of 1,800+ scientific and medical posters
3,500+ scientific and medical posters
A library of 2,500+ scientific videos on LabTube
5,200+ scientific videos