Visual Outcome of Patients with Idiopathic Intracranial Hypertension Treated with Oral Acetazolamide: A Single Centre Study

Author(s): Rahman MA, Rahman AKMS, Mulk MH, Romance NF, Muna ABY, Siddiqua RS, Rahman MM, Yasmin Z

Idiopathic intracranial hypertension (IIH) is a disorder primarily among overweight women of childbearing age, characterized by increased intracranial pressure (ICP) with its associated features. Acetazolamide (AZM) is commonly used to treat IIH, but there is insufficient information to establish an evidence base for its use. This study was designed to evaluate the visual outcome of patient with IIH treated with oral acetazolamide. A total of forty-nine (49) patients with IIH treated with oral acetazolamide (500 mg twice daily) were followed up after 3 months and 6 months. Bestcorrected visual acuity (BCVA) was recorded, visual field analysis was done and papilledema was graded accordingly. Mean value of the BCVA, scores of papilledema and mean deviations of the follow-up periods were compared with that of baseline values. The mean age of the study patients was 25.3±8.7 years with a female predominance (83.7%) and majority (65.3%) of them was over-weight/obese. Headache, nausea, double vision, transient vision loss, tinnitus, dimness of vision and low back pain were the presenting features. The mean cerebrospinal fluid (CSF) opening pressure of the study patients was 323.7±46.1 mm H2O. The mean BCVA in log MAR unit, perimetric mean deviation (PMD) and papilledema of both eyes were reduced significantly over time. In this study common side effects of AZM were paresthesia, dysgeusia, lethargy, anorexia, nausea and polyuria. This study concluded that oral acetazolamide 500 mg twice daily is effective in reduction of symptoms/signs and improve visual outcome among patients with idiopathic intracranial hypertension with minimum side effects.