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Factors Affecting Visual Field Outcomes in the Idiopathic Intracranial Hypertension Treatment Trial.
J Neuroophthalmol. 2016 Mar; 36(1):6-12.JN

Abstract

BACKGROUND

To determine the prevalence of visual field (VF) performance failures (PF) and treatment failures (TFs), and identify factors associated with PFs in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT).

METHODS

A total of 165 participants from 38 sites with idiopathic intracranial hypertension (IIH) and mild visual loss were randomized to either acetazolamide-plus diet or placebo-plus diet. The IIHTT Visual Field Reading Center evaluated 2950 Swedish Interactive Threshold Algorithm Standard 24-2 VFs from the enrolled participants. A TF was defined when the participant's VF mean deviation (MD) worsened ≥2 to 3 dB from the average baseline MD (range of -2 to -7 dB) with a second retest confirming the visual deterioration. A PF was determined when the participant's: 1) VF results met TF criteria but were not confirmed on retest, 2) deterioration was confirmed on retest but the IIHTT Adjudication Committee concluded a TF was clinically unlikely.

RESULTS

TF was detected in 7/165 (4%) of the participants and PF was detected in 35/165 (21%) of the participants on at least 1 examination. Four of the 35 PFs were adjudicated for TF, however based on clinical review by the adjudication committee and a third retest, they were judged as PFs. Of the 2,950 total IIHTT VF examinations, 2.7% met PF criteria.

CONCLUSIONS

PF was confirmed in 21% of subjects and in 2.7% of the total number of VF examinations and was reversible on repeat testing. We recommend retesting when perimetric worsening occurs in otherwise clinically stable or improving IIH patients.

Authors+Show Affiliations

Departments of Ophthalmology and Vision Science (KEC), and Neurology and Neurological Surgery (JLK), University of California Davis, California; Department of Ophthalmology and Visual Sciences (CAJ), University of Iowa, Iowa City, Iowa; and Department of Neurology and Ophthalmology (MW), College of Medicine, University of Iowa, Iowa City, Iowa.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26618282

Citation

Cello, Kimberly E., et al. "Factors Affecting Visual Field Outcomes in the Idiopathic Intracranial Hypertension Treatment Trial." Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society, vol. 36, no. 1, 2016, pp. 6-12.
Cello KE, Keltner JL, Johnson CA, et al. Factors Affecting Visual Field Outcomes in the Idiopathic Intracranial Hypertension Treatment Trial. J Neuroophthalmol. 2016;36(1):6-12.
Cello, K. E., Keltner, J. L., Johnson, C. A., & Wall, M. (2016). Factors Affecting Visual Field Outcomes in the Idiopathic Intracranial Hypertension Treatment Trial. Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society, 36(1), 6-12. https://doi.org/10.1097/WNO.0000000000000327
Cello KE, et al. Factors Affecting Visual Field Outcomes in the Idiopathic Intracranial Hypertension Treatment Trial. J Neuroophthalmol. 2016;36(1):6-12. PubMed PMID: 26618282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors Affecting Visual Field Outcomes in the Idiopathic Intracranial Hypertension Treatment Trial. AU - Cello,Kimberly E, AU - Keltner,John L, AU - Johnson,Chris A, AU - Wall,Michael, AU - ,, PY - 2015/12/1/entrez PY - 2015/12/1/pubmed PY - 2016/11/12/medline SP - 6 EP - 12 JF - Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society JO - J Neuroophthalmol VL - 36 IS - 1 N2 - BACKGROUND: To determine the prevalence of visual field (VF) performance failures (PF) and treatment failures (TFs), and identify factors associated with PFs in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT). METHODS: A total of 165 participants from 38 sites with idiopathic intracranial hypertension (IIH) and mild visual loss were randomized to either acetazolamide-plus diet or placebo-plus diet. The IIHTT Visual Field Reading Center evaluated 2950 Swedish Interactive Threshold Algorithm Standard 24-2 VFs from the enrolled participants. A TF was defined when the participant's VF mean deviation (MD) worsened ≥2 to 3 dB from the average baseline MD (range of -2 to -7 dB) with a second retest confirming the visual deterioration. A PF was determined when the participant's: 1) VF results met TF criteria but were not confirmed on retest, 2) deterioration was confirmed on retest but the IIHTT Adjudication Committee concluded a TF was clinically unlikely. RESULTS: TF was detected in 7/165 (4%) of the participants and PF was detected in 35/165 (21%) of the participants on at least 1 examination. Four of the 35 PFs were adjudicated for TF, however based on clinical review by the adjudication committee and a third retest, they were judged as PFs. Of the 2,950 total IIHTT VF examinations, 2.7% met PF criteria. CONCLUSIONS: PF was confirmed in 21% of subjects and in 2.7% of the total number of VF examinations and was reversible on repeat testing. We recommend retesting when perimetric worsening occurs in otherwise clinically stable or improving IIH patients. SN - 1536-5166 UR - https://www.unboundmedicine.com/medline/citation/26618282/Factors_Affecting_Visual_Field_Outcomes_in_the_Idiopathic_Intracranial_Hypertension_Treatment_Trial_ L2 - https://doi.org/10.1097/WNO.0000000000000327 DB - PRIME DP - Unbound Medicine ER -