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Abstract
Objective: To examine the changes in vision-specific and overall health-related quality of life (QOL) at 6 months in participants with idiopathic intracranial hypertension (IIH) and mild visual loss enrolled in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) and to determine the signs and symptoms of IIH that mediate the effect of acetazolamide on QOL.
Methods: We assessed QOL using the National Eye Institute Visual Function Questionnaire–25 (NEI-VFQ-25), the 10-Item NEI-VFQ-25 Neuro-Ophthalmic Supplement, and the 36-Item Short Form Health Survey (SF-36). We examined associations among changes in QOL measures over 6 months, treatment status, and changes in signs and symptoms using linear and structural equation models.
Results: Among the 165 participants with IIH (86 randomized to acetazolamide, 79 to placebo), beneficial effects of acetazolamide were seen on all QOL scales evaluated, as well as on the Near Activities (5.60 points, p = 0.03), Social Functioning (3.85 points, p = 0.04), and Mental Health (9.82, p = 0.04) subscales of the NEI-VFQ-25. Positive acetazolamide-related effects on QOL appeared to be primarily mediated by improvements in visual field, neck pain, pulsatile tinnitus, and dizziness/vertigo that outweighed the side effects of acetazolamide.
Conclusions: The marked reductions in baseline QOL seen among patients with mild visual loss from IIH are improved by treatment with acetazolamide. When combined with acetazolamide-associated improvements in visual field and other aspects of IIH, our findings with respect to QOL provide further support from the IIHTT in favor of acetazolamide to augment a dietary intervention in the treatment of IIH with mild visual loss (clinicaltrials.gov: NCT01003639).
GLOSSARY
- BMI=
- body mass index;
- CI=
- confidence interval;
- HIT-6=
- 6-item Headache Impact Test;
- IIH=
- idiopathic intracranial hypertension;
- IIHTT=
- Idiopathic Intracranial Hypertension Treatment Trial;
- NEI-VFQ-25=
- 25-item National Eye Institute Visual Function Questionnaire;
- MCS=
- Mental Component Summary;
- PCS=
- Physical Component Summary;
- PMD=
- perimetric mean deviation;
- QOL=
- quality of life;
- SF-36=
- Short Form–36;
- TVO=
- transient visual obscurations
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Coinvestigators are listed at Neurology.org.
Supplemental data at Neurology.org
- Received February 8, 2016.
- Accepted in final form July 18, 2016.
- © 2016 American Academy of Neurology
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