Sodium bicarbonate use in the treatment of idiopathic intracranial hypertension.

IF 2.8 3区医学 Q1 OPHTHALMOLOGY

Eye Pub Date : 2024-10-27 DOI:10.1038/s41433-024-03436-z

Mikayla J Baker, Ziou Jiang, Collin McClelland, Michael S Lee

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引用次数: 0

Abstract

Purpose: This retrospective case-control study from 2008 to 2022 aimed to determine the effect of adjunctive sodium bicarbonate (NaHCO₃) on treatment outcomes of and side effects of acetazolamide (ACZ) for the treatment of idiopathic intracranial hypertension (IIH).

Subjects/methods: Retrospective data was collected via chart review. 288 eyes of 144 patients with IIH, including those taking ACZ alone (control group, n = 89) vs. ACZ and NaHCO₃ (treatment group, n = 56). The primary outcome measure was time to IIH resolution. Secondary outcomes included retinal nerve fibre layer thickness (RNFL), visual field mean deviation (VFMD), visual acuity (VA), discontinuation ACZ, and patient-reported side effects of ACZ.

Results: Cox proportional hazards model for the primary outcome yielded a hazard ratio of 0.800, which was statistically insignificant (95% CI, 0.57-1.13; p = 0.200). There was no significant difference between groups when comparing RNFL, VFMD, VA, surgical intervention, or discontinuation of ACZ. The treatment group was more likely to experience side effects from ACZ prior to starting sodium bicarbonate therapy (p < 0.001). Among the treatment group, 92.7% remained on NaHCO₃ until IIH resolution, and 9 of 12 (75%) subjects reported significant improvement in ACZ-related side effects.

Conclusion: Sodium bicarbonate does not appear to impact treatment outcomes in patients taking acetazolamide for IIH. Sodium bicarbonate may represent a reasonable adjunctive medication to help mitigate acetazolamide-related side effects in this group of patients.

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使用碳酸氢钠治疗特发性颅内高压。

目的：这一2008年至2022年的回顾性病例对照研究旨在确定辅助性碳酸氢钠（NaHCO3）对乙酰唑胺（ACZ）治疗特发性颅内高压（IIH）的疗效和副作用的影响：通过病历回顾收集回顾性数据。144名特发性颅内高压患者的288只眼睛，包括单独服用ACZ（对照组，n = 89）与服用ACZ和NaHCO3（治疗组，n = 56）的患者。主要结果指标是IIH消退时间。次要结果包括视网膜神经纤维层厚度（RNFL）、视野平均偏差（VFMD）、视力（VA）、停用ACZ以及患者报告的ACZ副作用：主要结果的Cox比例危险模型得出的危险比为0.800，在统计学上并不显著（95% CI，0.57-1.13；P = 0.200）。在比较RNFL、VFMD、VA、手术干预或停用ACZ时，组间无明显差异。治疗组在开始碳酸氢钠治疗前更有可能出现 ACZ 副作用（p 3，直到 IIH 解除，12 例受试者中有 9 例（75%）报告 ACZ 相关副作用明显改善：结论：碳酸氢钠似乎不会影响服用乙酰唑胺治疗 IIH 患者的治疗效果。碳酸氢钠可能是一种合理的辅助药物，有助于减轻这类患者与乙酰唑胺相关的副作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Eye 医学-眼科学

CiteScore

6.40

自引率

5.10%

发文量

481

审稿时长

3-6 weeks

期刊介绍： Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists. Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.