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Retinal vessel diameter changes after 6 months of treatment in the Idiopathic Intracranial Hypertension Treatment Trial.
Br J Ophthalmol. 2020 10; 104(10):1430-1434.BJ

Abstract

BACKGROUND/AIMS

Prior studies support an association between increased retinal venule diameter and elevated intracranial pressure (ICP). The purpose of this study was to test the hypothesis that retinal venule diameters decrease in association with long-term therapy for high ICP in subjects with idiopathic intracranial hypertension (IIH).

METHODS

This is a retrospective analysis of multicentre randomised controlled trial data. Standardised procedures were used to measure area of optic nerve head elevation (ONHA) and diameters of 4 arterioles and 4 venules 2.7 mm from the optic disc centre on fundus photos collected at baseline and after 6 months of randomised treatment with placebo+diet or acetazolamide+diet in subjects participating in the IIH Treatment Trial (IIHTT) (n=115). Change in arteriole (Da) and venule (Dv) diameters from baseline to 6 months was studied as a function of IIH, haemodynamic and demographic variables.

RESULTS

Dv decreased following 6 months of therapy (8.1 µm, 5.9%, p<0.0005) but Da did not change. Dv change was associated with ONHA change (p<0.0005, r=0.47) and this association persisted in multiple variable models.

CONCLUSIONS

Retinal venule diameter decreased, and arteriole diameter did not change in association with treatment for elevated ICP with a weight loss intervention and placebo or acetazolamide in IIHTT participants. Further study is needed to determine how retinal vessel measurements can be combined with other clinical observations to inform disease management.

Authors+Show Affiliations

Byers Eye Institute, Stanford University, Palo Alto, California, USA hemoss@stanford.edu. Department of Neurology & Neurological Sciences, Stanford University, Stanford, California, USA.David and Ilene Flaum Eye Institute, University of Rochester, Rochester, New York, USA.David and Ilene Flaum Eye Institute, University of Rochester, Rochester, New York, USA.David and Ilene Flaum Eye Institute, University of Rochester, Rochester, New York, USA.

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
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

31949093

Citation

Moss, Heather E., et al. "Retinal Vessel Diameter Changes After 6 Months of Treatment in the Idiopathic Intracranial Hypertension Treatment Trial." The British Journal of Ophthalmology, vol. 104, no. 10, 2020, pp. 1430-1434.
Moss HE, Hollar RA, Fischer WS, et al. Retinal vessel diameter changes after 6 months of treatment in the Idiopathic Intracranial Hypertension Treatment Trial. Br J Ophthalmol. 2020;104(10):1430-1434.
Moss, H. E., Hollar, R. A., Fischer, W. S., & Feldon, S. E. (2020). Retinal vessel diameter changes after 6 months of treatment in the Idiopathic Intracranial Hypertension Treatment Trial. The British Journal of Ophthalmology, 104(10), 1430-1434. https://doi.org/10.1136/bjophthalmol-2019-314648
Moss HE, et al. Retinal Vessel Diameter Changes After 6 Months of Treatment in the Idiopathic Intracranial Hypertension Treatment Trial. Br J Ophthalmol. 2020;104(10):1430-1434. PubMed PMID: 31949093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retinal vessel diameter changes after 6 months of treatment in the Idiopathic Intracranial Hypertension Treatment Trial. AU - Moss,Heather E, AU - Hollar,Rachel A, AU - Fischer,William S, AU - Feldon,Steven E, Y1 - 2020/01/16/ PY - 2019/05/27/received PY - 2019/10/25/revised PY - 2019/12/21/accepted PY - 2020/1/18/pubmed PY - 2021/2/20/medline PY - 2020/1/18/entrez KW - diagnostic tests/investigation KW - imaging KW - optic nerve KW - retina SP - 1430 EP - 1434 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 104 IS - 10 N2 - BACKGROUND/AIMS: Prior studies support an association between increased retinal venule diameter and elevated intracranial pressure (ICP). The purpose of this study was to test the hypothesis that retinal venule diameters decrease in association with long-term therapy for high ICP in subjects with idiopathic intracranial hypertension (IIH). METHODS: This is a retrospective analysis of multicentre randomised controlled trial data. Standardised procedures were used to measure area of optic nerve head elevation (ONHA) and diameters of 4 arterioles and 4 venules 2.7 mm from the optic disc centre on fundus photos collected at baseline and after 6 months of randomised treatment with placebo+diet or acetazolamide+diet in subjects participating in the IIH Treatment Trial (IIHTT) (n=115). Change in arteriole (Da) and venule (Dv) diameters from baseline to 6 months was studied as a function of IIH, haemodynamic and demographic variables. RESULTS: Dv decreased following 6 months of therapy (8.1 µm, 5.9%, p<0.0005) but Da did not change. Dv change was associated with ONHA change (p<0.0005, r=0.47) and this association persisted in multiple variable models. CONCLUSIONS: Retinal venule diameter decreased, and arteriole diameter did not change in association with treatment for elevated ICP with a weight loss intervention and placebo or acetazolamide in IIHTT participants. Further study is needed to determine how retinal vessel measurements can be combined with other clinical observations to inform disease management. SN - 1468-2079 UR - https://www.unboundmedicine.com/medline/citation/31949093/Retinal_vessel_diameter_changes_after_6_months_of_treatment_in_the_Idiopathic_Intracranial_Hypertension_Treatment_Trial_ L2 - https://bjo.bmj.com/lookup/pmidlookup?view=long&amp;pmid=31949093 DB - PRIME DP - Unbound Medicine ER -