Acetazolamide and Thyroid-Associated Ophthalmopathy; a Preliminary Tested Hypothesis in a TertiaryReferral Center

Abstract This study evaluated the effect of acetazolamide on thyroid-associated ophthalmopathy (TAO). Patients with a VISA classification index equal to or more than four were enrolled in the study and were randomly assigned into two groups. In both groups, treatment was initiated using prednisolone. Patients in the case group received acetazolamide tablets ۲۵۰ mg daily in addition to prednisolone. Three months later, the VISA inflammatory score of patients in both groups were determined. Subsequent to intervention with acetazolamide, the VISA inflammatory score of patients in the case group were reduced as follows; orbital pain (۵۷.۱% versus ۴۱.۷%, P=۰.۷۳۶), eyelid edema (۴۲.۸% versus ۲۷.۱%, P=۰.۶۷), chemosis (۵۳.۳% versus ۳۳%, P=۰.۳۱), injection of the eyelids (۶۰% versus ۴۱.۶%, P=۰.۳۴۲), and conjunctival injection (۵۰% versus ۴۶.۱۳%, P=۰.۷۳). However, these reductions were not statistically significant when compared with those observed in the control group (P=۰.۲۴۶). In conclusion, the effect of acetazolamide on all the parameters of the VISA inflammatory score was examined independently. All patients in the case group revealed a reduction in VISA inflammatory score following intervention. However, these reductions were not statistically significant. Further studies with large sample sizes are required.