Efficacy of carbonic anhydrase inhibitors in management of cystoid macular edema in retinitis pigmentosa: A meta-analysis

Abstract

BackgroundCarbonic anhydrase inhibitors (CAI) are often used in the treatment of cystoid macular edema (CME) in retinitis pigmentosa (RP) patients. The aim of this meta-analysis is to gain a better understanding of the overall efficacy of CAI treatment.MethodsDatabases including PubMed, EMBASE, and Cochrane Library were searched to identify relevant studies. Eligible studies were clinical trials of patients with RP assigned topical or oral CAIs such as dorzolamide and acetazolamide. Changes in central macular thickness (CMT) by OCT in μm and best-corrected visual acuity (BCVA) in log MAR equivalents were extracted and results compared between baseline and after treatment.Results11 clinical reports were identified which included a total of 194 patients (358 eyes) available for analysis, with 59 patients (115 eyes) assigned oral CAI treatment and 135 patients (243 eyes) assigned topical CAI treatment. The combined results showed a significant reduction of macular edema, as calculated by baseline and final central macular thickness (CMT) based on OCT examination (46.02μm, 95%CI: -60.96, -31.08, I2 = 65%). However, the effect on visual acuity was inconsistent across studies.ConclusionBased on non randomized controlled clinical studies, RP patients with CME who were treated with CAIs had better anatomical outcomes, but the effect on visual acuity was contradictory across studies. Multicenter prospective randomized controlled trials would be ideal to definitively test its clinical efficacy in RP patients.

Outer retinal layers as predictors of visual acuity in retinitis pigmentosa: a cross-sectional study

“…Visual acuity was converted to the logarithm of minimum angle of resolution (logMAR) units for statistical analyses [19]. Hand movement, light perception, and no light perception were classified as + 2, + 3 and + 4, respectively [20][21][22]; tables and figures were used to summarize data as appropriate. Observational agreement was evaluated by kappa test.…”

Efficacy of Topical Brinzolamide Treatment in Posterior Microphthalmos- Related Macular Cystoid Lesions: A Case Series

“…Reduction in CLA and CFT were not correlated with change in VA except for patient 3. Previous studies in XLRS and RP reported that reduction of CFT was not correlated with improvement in VA. 11,23 The ages of our cases ranged from 4 to 39 years, and this difference should be considered in terms of drug efficacy and safety. In their study, Khandhadia et al 24 examined 4 patients diagnosed with XLRS, 3 of whom were children, and attributed eyes (c, d).…”

Resolution of bilateral foveal cysts in dome-shaped macula after treatment with topical dorzolamide

“…CAIs have widely been used as an adjunct for the treatment of macular cysts in various retinal pathologies 10. Chen et al reported a case of unilateral DSM with SRF, which responded to topical therapy with CAIs 3.…”