Use of acetazolamide for symptoms of visual vertigo
Reviewed by Claire Howard

Visual vertigo is a disorder characterised by symptoms of dizziness, vertigo, unsteadiness, disorientation and general discomfort induced by visual triggers. It is currently treated with vestibular rehabilitation therapy, with no effective pharmacotherapy options available for treatment resistant case. Oral acetazolamide has been reported to improve symptoms of dizziness in some patients. The authors present a study evaluating the efficacy of oral acetazolamide in improving symptoms of visual vertigo. Adult patients clinically diagnosed with the condition between 1992 and 2015 were identified and contacted to complete a symptom survey. The participants were then retrospectively divided into three groups based on their treatment with acetazolamide: currently on the drug, terminated the drug, or never initiated the drug. Fifty-seven patients were included in the study (19 currently on acetazolamide, 27 terminated use and five who never initiated therapy). Overall symptomatic improvement was reported by 18 (94.7%) patients currently on acetazolamide, 18 (66.7%) who terminated acetazolamide and five (45.5%) who never initiated therapy, varying significantly by group (p=0.0061). The authors discuss these results and suggest that acetazolamide has a positive association with improvement of symptoms of visual vertigo. The study has limitations with its retrospective nature, with the authors discussing this as a possible area of future research using a multi-centre randomised controlled trial to support the association further.

Acetazolamide: a new treatment for visual vertigo.
Sluch IM, Elliott MS, Dvorak J, et al.
NEURO-OPHTHALMOLOGY
2017;41(6):315-20.