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Cochrane Database of Systematic Reviews

Intervenciones para la hipertensión intracraneal idiopática

Información

DOI:
https://doi.org/10.1002/14651858.CD003434.pub3Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 07 agosto 2015see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:

  1. Grupo Cochrane de Salud ocular y de la visión

Copyright:
  1. Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Autores

  • Rory J Piper

    Correspondencia a: University of Edinburgh, Edinburgh, UK

    [email protected]

  • Aristotelis V Kalyvas

    University of Edinburgh, Edinburgh, UK

  • Adam MH Young

    University of Glasgow, Glasgow, UK

    Institute of Neurological Science, Southern General Hospital, Glasgow, UK

  • Mark A Hughes

    University of Edinburgh, Edinburgh, UK

    Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK

  • Aimun AB Jamjoom

    Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK

  • Ioannis P Fouyas

    Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK

Contributions of authors

CL and GM conceived and designed the review (Lueck 2002; Lueck 2005).

Original review

CL wrote the protocol and discussed the search strategy with the Cochrane Eyes and Vision Group editorial team. He was responsible for reading and assessing studies identified by the search (with regard to both inclusion criteria and quality), and for writing the definitive review.
GM also read and assessed studies identified by the search (with regard to both inclusion criteria and quality), and assisted in the writing of the definitive review.
CL coordinated the review and screened the search results.
CL and GM screened the retrieved papers against inclusion criteria, and appraised the quality of the papers.
CL wrote the review.

2015 update

RJP coordinated the review update.
RJP and AMHY screened the search results.
AABJ acted as a third party decision on screening disagreements.
RJP and AABJ screened retrieved papers against inclusion criteria and appraised the quality of the papers.
RJP, AVK, AMHY, MAH, AABJ and IPF wrote the review.

Sources of support

Internal sources

  • No sources of support supplied

External sources

  • National Institute for Health Research (NIHR), UK.

    • Richard Wormald, Co‐ordinating Editor for the Cochrane Eyes and Vision Group (CEVG) acknowledges financial support for his CEVG research sessions from the Department of Health through the award made by the National Institute for Health Research to Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology for a Specialist Biomedical Research Centre for Ophthalmology.

    • The NIHR also funds the CEVG Editorial Base in London.

    The views expressed in this publication are those of the authors and not necessarily those of the NIHR, NHS, or the Department of Health.

Declarations of interest

RJP, AMHY, AABJ, AVK, MAH, IPF: none known.

Acknowledgements

We have used text adapted from a standard template used by the Cochrane Eyes and Vision Review Group (CEVG) in the Methods section.
We thank James Acheson for peer review comments on the original version of this review.
The CEVG developed and performed the electronic searches. We thank Jennifer Evans and Anupa Shah from the CEVG editorial team for their assistance with the review process.
We thank Christian Lueck (CL) and Gawn McIllwaine (GM) for their work on the original published versions of this review (Lueck 2002; Lueck 2005).

Version history

Published

Title

Stage

Authors

Version

2015 Aug 07

Interventions for idiopathic intracranial hypertension

Review

Rory J Piper, Aristotelis V Kalyvas, Adam MH Young, Mark A Hughes, Aimun AB Jamjoom, Ioannis P Fouyas

https://doi.org/10.1002/14651858.CD003434.pub3

2005 Jul 20

Interventions for idiopathic intracranial hypertension

Review

Christian J Lueck, Gawn G McIlwaine

https://doi.org/10.1002/14651858.CD003434.pub2

2002 Jul 22

Interventions for idiopathic intracranial hypertension

Review

Christian J Lueck, G McIlwaine

https://doi.org/10.1002/14651858.CD003434

Differences between protocol and review

We have updated the protocol of this review in line with current methodological expectations for Cochrane reviews. Therefore there are some differences compared with the original published protocol. However, we did not use these updated methods in this review version because only two trials met the inclusion criteria and we were unable to perform meta‐analysis. We may use the updated methods in future review updates.

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Adult; Female; Humans; Male; Middle Aged;

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Study flow diagram.
Figuras y tablas -
Figure 1

Study flow diagram.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Table 1. Reduction in vision according to change in perimetric mean deviation

Outcome

Acetalomazide

Placebo

MD (95% CI) adjusted for centre, baseline value of outcome and baseline papilloedema grade, with multiple imputation for missing data

Mean

SD

N

Mean

SD

N

Wall 2014: Change in perimetric mean deviation (decibels) between baseline and 6 months

1.43

2.23

86

0.71

2.49

69

0.71 (0 to 1.43)

Abbreviations: MD = mean difference; SD = standard deviation; CI = confidence interval.
Figuras y tablas -
Table 1. Reduction in vision according to change in perimetric mean deviation
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Table 2. Reduction in vision according to change in logMAR acuity

Outcome

Acetalomazide

Placebo

MD (95% CI)

Mean

SD

N

Mean

SD

N

Ball 2011: Change in logMAR acuity in the right eye between baseline and 12 months

Not reported

Not reported

21

Not reported

Not reported

20

0.04 (‐0.08, 0.16)

Ball 2011: Change in logMAR acuity in the left eye between baseline and 12 months

Not reported

Not reported

21

Not reported

Not reported

20

0.03 (‐0.09, 0.15)

Wall 2014a: Change in visual acuity (number of correct letters) between baseline and 6 months

2.65

Not reported (SE 0.49)

b

2.64

Not reported (SE 0.51)

b

0.01 (‐1.45, 1.46)

aIn Wall 2014 MD adjusted for centre, baseline value of outcome and baseline papilloedema grade.
bIt is unclear how many patients were included in these analyses.
Abbreviations: MD = mean difference; SD = standard deviation; CI = confidence interval; SE = standard error.

Figuras y tablas -
Table 2. Reduction in vision according to change in logMAR acuity
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Table 3. Reduction in patients with visual loss according to change in logMAR acuity

Outcome

Acetalomazide

Placebo

OR (95% CI)

n

N

n

N

Ball 2011: Visual loss (logMAR 0.2 or more) at 12 months

0

21

2

20

0.17 (0.01, 3.82)

Abbreviations: MD = mean difference; SD = standard deviation; CI = confidence interval; n = number of events; N = number of participants; OR = odds ratio.

Figuras y tablas -
Table 3. Reduction in patients with visual loss according to change in logMAR acuity
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Table 4. Reduction in cerebrospinal fluid pressure

Outcome

Acetalomazide

Placebo

MD (95% CI) adjusted for centre, baseline value of outcome and baseline papilloedema grade

Mean

SD

N

Mean

SD

N

Wall 2014: Change in CSF pressure (mmH20) between baseline and 6 months

‐112.3

Not reported

47

‐52.4

Not reported

38

‐59.9 (‐96.4 to ‐23.4)
Figuras y tablas -
Table 4. Reduction in cerebrospinal fluid pressure
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Table 5. Resolution of papilloedema or oculomotor disorder or both

Outcome

Acetalomazide

Placebo

MD (95% CI) adjusted for centre and baseline papilloedema grade

Mean

SD

N

Mean

SD

N

Wall 2014: Change in papilloedema grade between baseline and 6 months, graded by fundus photographs

‐1.31

SE 0.11a

a

‐0.61

SE 0.11a

a

‐0.70 (‐1.00 to ‐0.40)

Wall 2014: Change in papilloedema grade between baseline and 6 months, clinical grading

‐1.75

SE 0.13a

a

‐0.85

SE 0.14a

a

‐0.91 (‐1.27 to ‐0.54)

aIt is unclear how many patients were included in these analyses.
Abbreviations: MD = mean difference; SD = standard deviation; SE = standard error; CI = confidence interval; N = number of participants.

Figuras y tablas -
Table 5. Resolution of papilloedema or oculomotor disorder or both
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Table 6. Improvement in headache

Outcome

Acetalomazide

Placebo

MD (95% CI) adjusted for centre, baseline value of outcome and baseline papilloedema grade

Mean

SD

N

Mean

SD

N

Ball 2011: Change in headache score as measured on a 10‐point visual analogue score at 12 months

Not reported

Not reported

21

Not reported

Not reported

20

1.0 (‐1.80 to 3.70)

Wall 2014: Change in HIT‐6 total score between baseline and 6 months

‐9.56

Not reporteda

a

‐9.11

Not reporteda

a

‐0.45 (‐3.50 to 2.60)

aIt is unclear how many patients were included in these analyses.
Abbreviations: MD = mean difference; SD = standard deviation; CI = confidence interval; N = number of participants.

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Table 6. Improvement in headache
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Table 7. Resolution of headache

Outcome

Acetalomazide

Placebo

OR (95% CI)

n

N

n

N

Ball 2011: Number of people with headache at 12 months

9

21

13

20

0.42 (0.12 to 1.41)

Abbreviations: CI = confidence interval; n = number of events; N = number of participants; OR = odds ratio.

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Table 7. Resolution of headache
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Table 8. Remission rate

Outcome

Acetalomazide

Placebo

OR (95% CI)

n

N

n

N

Ball 2011: Number of people in remission at 12 months

9

21

8

20

1.13 (0.32 to 3.90)

Abbreviations: CI = confidence interval; n = number of events; N = number of participants; OR = odds ratio.

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Table 8. Remission rate
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Table 9. Side effects

Outcome

Acetalomazide

Placebo

OR (95% CI)

n

N

n

N

Elevated ALT

6

69

3

79

1.90 (0.46 to 7.87)

Decreased CO2

9

69

0

79

19.49 (1.12 to 340.66)

Diarrhea

12

69

3

79

4.11 (1.11 to 15.15)

Dizziness

8

69

3

79

2.60 (0.66 to 10.16)

Dysgeusia

13

69

0

79

29.20 (1.71 to 500.07)

Dyspepsia

7

69

1

79

6.91 (0.83 to 57.49)

Dyspnea

7

69

2

79

3.41 (0.69 to 16.94)

Fatigue

14

69

1

79

15.17 (1.94 to 118.27)

Headache

13

69

11

79

1.10 (0.46 to 2.62)

Nasopharyngitis

5

69

8

79

0.55 (0.17 to 1.75)

Nausea

26

69

10

79

2.99 (1.33 to 6.70)

Paresthesia

41

69

5

79

13.48 (4.96 to 36.64)

Post‐LP syndrome

5

69

6

79

0.75 (0.22 to 2.56)

Rash

7

69

2

79

3.41 (0.69 to 16.94)

Sinusitis

3

69

6

79

0.44 (0.11 to 1.82)

Tinnitus

11

69

3

79

3.72 (1.00 to 13.85)

Vomiting

12

69

3

79

4.11 (1.11 to 15.15)

This data is from one study (Wall 2014).

Abbreviations: CI = confidence interval; n = number of events; N = number of participants; OR = odds ratio.

Figuras y tablas -
Table 9. Side effects
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Table 10. Quality of life

Outcome

Acetalomazide

Placebo

MD (95% CI) adjusted for centre, baseline value of outcome and baseline papilloedema grade

Mean

SD

N

Mean

SD

N

Wall 2014: Change in VFQ‐25 total score between baseline and 6 months

8.33

SE 1.47a

a

1.98

SE 1.53a

a

6.35 (2.22 to 10.47)

Wall 2014: Change in VFQ‐25 10‐item neuro‐ophthalmic supplement between baseline and 6 months

9.82

SE 1.55a

a

1.59

SE 1.62a

a

8.23 (3.89 to 12.56)

Wall 2014: Change in SF‐36 Physical Component Summary between baseline and 6 months

5.84

SE 1.01a

a

2.82

SE 1.03a

a

3.02 (0.34 to 5.70)

Wall 2014: Change in SF‐36 Mental Component Summary between baseline and 6 months

5.62

SE 1.16a

a

2.17

SE 1.17a

a

3.45 (0.35 to 6.55)

aIt is unclear how many patients were included in these analyses.
Abbreviations: CI = confidence interval; N = number of participants; SE = standard error; SD = standard deviation.

Figuras y tablas -
Table 10. Quality of life
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