Reduction of macular oedema by acetazolamide in patients with chronic iridocyclitis: a randomised prospective crossover study.

Abstract

Thirty patients with cystoid macular oedema secondary to chronic iridocyclitis were enrolled in a two period, prospective, randomised, double masked, crossover study that compared sustained release acetazolamide (500 mg twice a day) with a placebo to measure the effects on the reduction of cystoid macular oedema and improvement of visual acuity. AU patients were treated for 1 month with either acetazolamide or placebo, received no treatment for 1 month, and were then treated for 1 month with the other medication. Statistically significant improvement in visual acuity was seen at 14 and 28 days in the treated patients. No improvement was seen when patients received placebo. Improved visual acuity was not associated with race or sex. However, younger patients (under age 55 years) were more likely to benefit from treatment. Results of vitreous fluorophotometry, obtained at baseline and 4 weeks, demonstrated an improvement in posterior vitreous penetration ratios and mid vitreous penetration ratios after treatment with acetazolamide but not with placebo. (Br_J Ophthalmol 1994; 78: 4-7)

Infrared imaging of cystoid macular edema

“…Therapy includes pharmacological approaches [8,21] and laser treatment in some diseases such as diabetic macular edema [4,15,22]. Treatment may prevent severe central visual loss and seems to be adequate when CME is considered as significant, defined as a drop of visual acuity below 20/40.…”

Macular grid laser photocoagulation in uveitis.

“…2 The major cause of visual loss in chronic uveitis is cystoid macular oedema, which can persist despite aggressive treatment and resolution of active inflammation. Symptomatic treatment includes topical and systemic anti-inflammatory drugs -steroids as well as non-steroids -and oral acetazolamide.2 3 Hyperbaric oxygen and surgical therapy (vitrectomy) are still controversial.4" Non-uveitic causes of chronic cystoid macular oedema include diseases with a vascular pathogenesis -for example, diabetic maculopathy, branch vein and central vein occlusion, and surgical trauma -for example, aphakic cystoid macular oedema. It is generally accepted that grid laser photocoagulation of the macula can enhance the resolution of long standing oedema and improve visual outcome in cystoid macular oedema of vascular origin.7-'2 Whether laser treatment is also beneficial in the treatment of cystoid macular oedema in uveitis is not known and was the subject of this retrospective study.…”

Intravitreal and Orbital Floor Triamcinolone Acetonide Injections in Noninfectious Uveitis: A Comparative Study

“…Previously, it has been described that CME improved after oral administration of acetazolamide. However, the therapeutic value of acetazolamide for CME is controversial and its use may be limited by side effects [2][3][4][5][6] . The mainstay of CME treatment is anti-inflammatory medication.…”