Trial reportJournal of the neurological sciences2017
Role of vitamin A metabolism in IIH: Results from the idiopathic intracranial hypertension treatment trial.
Trial report in Journal of the neurological sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 46 citations in OpenAlex.
- Inflammation in Idiopathic Intracranial Hypertension: An Immunometabolic Mechanistic Framework and Clinical Implications.CNS neuroscience & therapeutics · 2026Review
- When Vitamin Supplementation May Cause More Harm Than Good-An Avoidable Case of Intracranial Hypertension.Pediatric discovery · 2026Article
- Antioxidant Supplementation in Childhood Obesity: A Path to Improved Metabolic Health?Antioxidants (Basel, Switzerland) · 2025Review
- The Impact of Idiopathic Intracranial Hypertension on Cardiovascular Disease Risk Among UK Women: An Obesity-Adjusted Analysis.ASIDE internal medicine · 2025Article
- Metabolic Dysfunction in Idiopathic Intracranial Hypertension: Current Theories and Updates.Aging and disease · 2024Review
- Progress and recognition of idiopathic intracranial hypertension: A narrative review.CNS neuroscience & therapeutics · 2024Review
- Association between serum vitamin A and body mass index in adolescents from NHANES 1999 to 2006.Scientific reports · 2024Article
- The Multitarget Action of Vitamins in the Ischemic Stroke.Current topics in medicinal chemistry · 2024Review
- Bilateral compressive optic neuropathy and outer retinopathy due to optic canal hyperostosis in a child with isolated vitamin a deficiency.Documenta ophthalmologica. Advances in ophthalmology · 2023Article
- Retinoid homeostasis in major depressive disorder.Translational psychiatry · 2023Article
- Better Bioactivity, Cerebral Metabolism and Pharmacokinetics of Natural Medicine and Its Advanced Version.Frontiers in pharmacology · 2022Review
- An update on idiopathic intracranial hypertension in adults: a look at pathophysiology, diagnostic approach and management.Journal of neurology · 2021Review
- Serum Retinal and Retinoic Acid Predict the Development of Type 2 Diabetes Mellitus in Korean Subjects with Impaired Fasting Glucose from the KCPS-II Cohort.Metabolites · 2021Article
- All-Trans Retinoic Acid-Induced Ototoxicity during Chemotherapy in Pediatric Acute Promyelocytic Leukemia.Children (Basel, Switzerland) · 2021Article
- Guide to preclinical models used to study the pathophysiology of idiopathic intracranial hypertension.Eye (London, England) · 2020Review
- Ocular manifestations in celiac disease: an overview.International ophthalmology · 2020Review
- Acute presentation of idiopathic intracranial hypertension with severe vision deficits.SAGE open medical case reports · 2020Article
- An Up to Date Review of Pseudotumor Cerebri Syndrome.Current neurology and neuroscience reports · 2018Review
- Current concepts and strategies in the diagnosis and management of idiopathic intracranial hypertension in adults.Journal of neurology · 2017Review
- Pathogenesis and management of idiopathic intracranial hypertension: A narrative review.Brain circulationReview
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
Abstract
introductionVitamin A and its metabolites (called retinoids) have been thought to play a role in the development of idiopathic intracranial hypertension (IIH). The IIH Treatment Trial (IIHTT) showed the efficacy of acetazolamide (ACZ) in improving visual field function, papilledema grade, quality of life and cerebrospinal fluid (CSF) pressure. We postulated that IIH patients would demonstrate elevated measures of vitamin A metabolites in the serum and CSF.
methodsComprehensive measures of serum vitamin A and its metabolites were obtained from 96 IIHTT subjects, randomly assigned to treatment with ACZ or placebo, and 25 controls with similar gender, age and body mass index (BMI). These included retinol, retinol binding protein, all-trans retinoic acid (ATRA), alpha- and beta-carotenes, and beta-cryptoxanthin. The IIHTT subjects also had CSF and serum vitamin A and metabolite measurements obtained at study entry and at six months.
resultsAt study entry, of the vitamin A metabolites only serum ATRA was significantly different in IIHTT subjects (median 4.33nM) and controls (median 5.04nM, p=0.02). The BMI of IIHTT subjects showed mild significant negative correlations with serum ATRA, alpha- and beta-carotene, and beta-cryptoxanthin. In contrast, the control subject BMI correlated only with serum ATRA. At six months, the serum retinol, alpha-carotene, beta-carotene, and CSF retinol were increased from baseline in the ACZ treated group, but only increases in alpha-carotene (p=0.02) and CSF ATRA (p=0.04) were significantly greater in the ACZ group compared with the placebo group. No other vitamin A measures were significantly altered over the six months in either treatment group. Weight loss correlated with only with the change in serum beta-carotene (r=-0.44, p=0.006) and the change in CSF retinol (r=-0.61, p=0.02).
conclusionVitamin A toxicity is unlikely a contributory factor in the causation of IIH. Our findings differ from those of prior reports in part because of our use of more accurate quantitative methods and measuring vitamin A metabolites in both serum and CSF. ACZ may alter retinoid metabolism in IIH patients.
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