Department of Ophthalmology, Strabismus and Neuro-ophthalmology Services, Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Department of Physiology, Cognitive Neurophysiology Lab, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2024 Jul 1;72(7):976-982. doi: 10.4103/IJO.IJO_1010_23. Epub 2024 Jun 22.
To evaluate the effect of topical carbonic anhydrase inhibitor (brinzolamide) versus placebo on visual function and waveforms in infantile nystagmus syndrome (INS).
Prospective, placebo-controlled, double-blind, cross-over study.
Setting- A tertiary eye care center. Patients- Cases of idiopathic INS with and without abnormal head posture aged ≥10 years who had not received previous treatment for nystagmus. Intervention- Patients were randomized into two groups. Group 1 was given placebo for 3 months, and after a washout period of 7 days started on topical brinzolamide for the next 3 months. In group 2, the order was reversed. The drops were administered topically three times (every 8 hours) in both eyes. Outcome measure- Binocular best corrected visual acuity (BCVA) using the ETDRS chart, eXpanded nystagmus acuity function (NAFX) score and INS waveforms obtained from eye movement recordings, intraocular pressure (IOP) by Goldmann applanation tonometer, near stereopsis by TNO stereo test, and change in abnormal head posture before and after intervention in the null position.
A total of 29 cases completed the study (23 with abnormal head posture; 6 without abnormal head posture).
A significant improvement was noted in INS waveform characteristics, mean NAFX score (P < 0.001), and mean binocular visual acuity (P < 0.001) with topical brinzolamide in comparison to baseline as well as placebo. No significant change in head position and stereopsis was noted. No side effects were reported with 3 months of brinzolamide therapy.
While brinzolamide shows improvement in visual acuity and NAFX score in idiopathic INS, its clinical significance needs further evidence.
评估局部碳酸酐酶抑制剂（布林佐胺）与安慰剂对婴儿性眼球震颤综合征（INS）患者视觉功能和眼震波的影响。
前瞻性、安慰剂对照、双盲、交叉研究。
地点-三级眼科中心。患者-患有特发性 INS 且伴有或不伴有异常头位的年龄≥10 岁的患者，且未曾接受过眼震治疗。干预-患者随机分为两组。第 1 组接受 3 个月的安慰剂治疗，洗脱期 7 天后开始接受为期 3 个月的局部布林佐胺治疗。第 2 组的顺序相反。两种药物均滴入双眼，每日 3 次（每 8 小时 1 次）。观察指标-双眼最佳矫正视力（BCVA）（采用 ETDRS 图表）、扩展眼球震颤视力功能（NAFX）评分和眼动记录获得的 INS 眼震波、Goldmann 压平眼压计测量的眼压（IOP）、TNO 立体测试获得的近立体视功能，以及干预前后异常头位在零位时的变化。
共有 29 例患者完成了研究（23 例伴有异常头位；6 例无异常头位）。
与基线和安慰剂相比，局部布林佐胺治疗后，眼震波特征、平均 NAFX 评分（P<0.001）和双眼平均视力（P<0.001）均有显著改善。头位和立体视功能无明显变化。布林佐胺治疗 3 个月未见不良反应。
布林佐胺可改善特发性 INS 的视力和 NAFX 评分，但还需要进一步的证据来证实其临床意义。
