Eye Health

Updated 15 March 2018

Glaucoma drug may help obesity-related vision loss

Adding acetazolamide to a weight-loss plan boosted vision improvement in patients with idiopathic intracranial hypertension.

A drug used to treat glaucoma can also help people with vision loss linked to obesity, a new study reveals.

Researchers examined the effectiveness of the inexpensive drug, called acetazolamide (Diamox), in women and men with the condition known as "idiopathic intracranial hypertension". According to the researchers, the disorder primarily affects overweight women of reproductive age, and 5% to 10% of women with it suffer disabling vision loss.

This study included 161 women and four men with idiopathic intracranial hypertension and mild vision loss. The investigators found that adding acetazolamide to a weight-loss plan featuring calorie reduction, lowered salt intake and exercise boosted vision improvement in these patients.

Read: More on benign intracranial hypertension

Specifically, the vision of those who took the drug improved twice as much after six months compared to those who took an inactive placebo, according to the US National Eye Institute-funded study published in the Journal of the American Medical Association.

"Our results show that acetazolamide can help preserve and actually restore vision for women with [idiopathic intracranial hypertension] when combined with a moderate but comprehensive dietary and lifestyle modification plan," Dr Michael Wall, a professor of neurology and ophthalmology at the University of Iowa in Iowa City, said in a National Eye Institute (NEI) news release.

No established treatment guidelines

Doctors need more guidance in treating this condition, another expert noted.

"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," Eleanor Schron, director of clinical applications at NEI, said in the news release.

Read: Glaucoma in a nutshell

Swelling and damage to the optic nerve

Idiopathic intracranial hypertension occurs when increased pressure within the fluid-filled spaces inside and around the brain causes swelling and damage to the optic nerve, according to the news release. Common symptoms include headache and eye problems such as blind spots, poor side vision, double vision and temporary spells of blindness.

Acetazolamide reduces fluid production in the brain and is often used as an additional treatment – along with weight loss – for people with idiopathic intracranial hypertension. However, there has been little evidence that the drug is effective in such cases.

About 100 000 Americans have idiopathic intracranial hypertension, according to the news release, and that number is rising due to the nation's obesity epidemic.

Read more:

Glaucoma: the silent thief of sight
Risk factors for glaucoma identified

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Megan Goodman qualified as an optometrist from the University of Johannesburg. She has recently completed a Masters degree in Clinical Epidemiology at Stellenbosch University. She has a keen interest in ocular pathology and evidence based medicine as well as contact lenses.

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