title: Topical brinzolamide (Azopt) versus placebo in the treatment of infantile nystagmus syndrome (INS).
abstract: OBJECTIVE
  To test the hypothesis that the topical carbonic anhydrase inhibitor brinzolamide (Azopt) has beneficial effects versus placebo on measures of nystagmus and visual acuity in adult subjects with infantile nystagmus syndrome (INS).
  
  
  METHODS
  Prospective, cross-over, double masked clinical trial.
  
  
  METHODS
  
  
  
  METHODS
  Single centre.
  
  
  METHODS
  Five subjects ≥18 years old with typical INS and best-binocular visual acuity in their primary position null zone ETDRS 55 letters to 85 letters (20/200 to 20/50) and had no previous treatment for nystagmus.
  
  
  METHODS
  In a randomised order, each subject received one drop of Azopt or placebo in both eyes three times a day separated by a washout period of at least a week followed by Azopt or placebo in both eyes three times a day; thus each subject got the drug and placebo, each acting as his or her own control.
  
  
  METHODS
  The nystagmus acuity function and INS waveforms obtained from eye movement recordings, binocular optotype visual acuity, using the ETDRS protocol analysed individually and as a group before and after Azopt and placebo.
  
  
  RESULTS
  Versus placebo and baseline measures, topical Azopt significantly improved; INS waveform characteristics in the primary position null zone, group mean values of the nystagmus acuity function across gaze (p<0.01) and group mean ETDRS binocular letter visual acuity (p<0.05). There was a predictable decrease in intraocular pressure (IOP) without any systemic or ocular adverse events.
  
  
  CONCLUSIONS
  Although a prospective large-scale clinical trial is needed to prove effectiveness, an eye-drop-based therapy for INS may emerge as a viable addition to optical, surgical, behavioural and systemic drug therapies for INS.
  
  
  BACKGROUND
  NCT01312402.
authors.affiliation: Children's Hospital Medical Center, Akron, Ohio, USA Department of Ophthalmology, SUMMA Medical Center, Akron, OH, USA NEOMED, Rootstown, OH, USA.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Hertle
authors.affiliation: Children's Hospital Medical Center, Akron, Ohio, USA NEOMED, Rootstown, OH, USA.
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Yang
authors.affiliation: Children's Hospital Medical Center, Akron, Ohio, USA.
authors.forename: Tonia
authors.initials: T
authors.lastname: Adkinson
authors.affiliation: Children's Hospital Medical Center, Akron, Ohio, USA Department of Ophthalmology, SUMMA Medical Center, Akron, OH, USA NEOMED, Rootstown, OH, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Reed
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000188:drug therapy* / Q000503:physiopathology; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D013843:Thiazines / Q000627:therapeutic use*; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D009883:Ophthalmic Solutions; D013449:Sulfonamides; D013843:Thiazines; C111827:brinzolamide
keywords: Clinical Trial; Muscles; Treatment Medical