The clinical efficacy of a topical dorzolamide in the management of cystoid macular edema in patients with retinitis pigmentosa

Ikeda, Yasuhiro; Hisatomi, Toshio; Yoshida, Noriko; Notomi, Shoji; Murakami, Yusuke; Enaida, Hiroshi; Ishibashi, Tatsuro

doi:10.1007/s00417-011-1904-5

Cited by 58 publications

(58 citation statements)

References 21 publications

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“…This group of drugs is commonly used to treat macular oedema associated with RP. [4][5][6] Acetazolamide increases fluid transport through the retinal pigment epithelium (RPE) by active ion transport and acidification of the RPE. 7 Macular oedema owing to low-grade inflammation may respond better to this mechanism than the diffuse loss of endothelial tight junctions that occurs in diabetes.…”

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confidence: 99%

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Resolution of macular oedema associated with retinitis pigmentosa after intravitreal use of autologous BM-derived hematopoietic stem cell transplantation

Siqueira

Messias

Voltarelli

et al. 2012

Bone Marrow Transplant

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confidence: 99%

“…Topical carbonic anhydrase inhibitors have a lower rate of systemic side effects than acetazolamide but are less efficacious. 4 CME that is refractory to acetazolamide treatment usually leads to permanent visual acuity loss. 5,6 Thus, the short time of response after the injection of auto-BMHSCT is strong evidence for the action of this therapy.…”

mentioning

confidence: 99%

Resolution of macular oedema associated with retinitis pigmentosa after intravitreal use of autologous BM-derived hematopoietic stem cell transplantation

Siqueira

Messias

Voltarelli

et al. 2012

Bone Marrow Transplant

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“…1,2 Central vision is relatively spared up to the later stages of the disease process. 3 However, when macular complications such as macular oedema arise, central vision is often dramatically impaired even in the early stages of the disease. The prevalence of cystoid macular oedema (CME) is reported to be 10-20% in the eyes of patients with RP.…”

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confidence: 99%

Intravitreal Pharmacotherapy in the Treatment of Retinitis Pigmentosa-related Cystoid Macular Oedema

Dönmez¹,

Saatçi²

2017

European Ophthalmic Review

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P eripheral visual field constriction and night blindness are the main features of retinitis pigmentosa (RP). However, central vision is often impaired dramatically even in the early stages of the disease when macular complications such as cystoid macular oedema (CME) occur. The pathogenesis of RP-related CME is still not well explained. Therefore, several treatment alternatives such as topical, oral and systemic pharmacotherapy; laser photocoagulation and even vitreoretinal surgery are employed by the clinicians. In this review, we summarise the clinical data on intravitreal pharmacotherapeutic agents and focus mainly on the steroids and anti-vascular endothelial growth factor agents. KeywordsAflibercept, intravitreal injection, macula, macular oedema, Ozurdex ® , ranibizumab, retinitis pigmentosa, steroid, vascular endothelial growth factor Disclosure: Oya Donmez and Ali Osman Saatci have nothing to disclose in relation to this article. No funding was received for the publication of this article. This study involves a review of the literature and did not involve any studies with human or animal subjects performed by any of the authors Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole and have given final approval for the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. 1,2 Night blindness together with the peripheral visual field loss is the most prominent clinical feature.1,2 Central vision is relatively spared up to the later stages of the disease process.3 However, when macular complications such as macular oedema arise, central vision is often dramatically impaired even in the early stages of the disease. The prevalence of cystoid macular oedema (CME) is reported to be 10-20% in the eyes of patients with RP. 4,5The pathogenesis of RP-related CME is still unclear. Blood-retinal barrier (BRB) impairment, retinal pigment epithelium (RPE) pump disturbance, inflammation, autoimmunity and vitreoretinal interface changes may be among the potential causes of CME. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] Fishman et al. 6 examined 15 RP patients with vitreous fluorophotometry. All patients showed abnormally high concentrations of fluorescein within the vitreous which was a sign of BRB abnormality. Larsen et al. 7 demonstrated that BRB leakage was markedly increased in six RP patients with the help of ocular spectrofluorophotometry. Vinores et al. 9 investigated the immunohistochemical staining for albumin on paraffin sections of 22 normal and 29 RP eyes.Electron microscopic immunocytochemical staining for albumin was performed on additional six normal and nine RP-affected eyes. Two-thirds of the eyes with RP demonstrated extr...

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“…Visual acuity, usually preserved until a late stage [10], can be affected by cystoid macular edema (CME) in 10-40% of cases diagnosed with RP [11,12,13] and 8-25% of cases diagnosed with US [9,14,15]. Several factors have been connected to visual deterioration, namely cell loss and subsequent atrophic thinning of the retina and retinal thickening [16] induced by swelling either of the fovea or the parafovea [17].…”

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confidence: 99%

“…The therapeutic approaches previously described are numerous and include the use of periocular or intravitreal steroid injection [21,22,23,24,25], intravitreal bevacizumab [26], grid laser photocoagulation [27,28], pars plana vitrectomy [29] and the administration of topical or oral carbonic anhydrase inhibitors [10,30,31,32,33]. …”

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Comparison of Topical Dorzolamide and Ketorolac Treatment for Cystoid Macular Edema in Retinitis Pigmentosa and Usher's Syndrome

et al. 2014

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Purpose: To investigate the topical effect of dorzolamide versus ketorolac on retinitis pigmentosa (RP) and Usher's syndrome (US) macular edema. Methods: Prospective, randomized and interventional study. A total of 28 eyes of 18 patients were included. Five eyes had US, 23 had RP. Fifteen eyes were allocated to ketorolac tromethamine 0.5% (4 drops daily regimen) and 13 eyes to dorzolamide hydrochloride 2% (3 drops daily regimen) treatment groups. Snellen's best-corrected visual acuity (BCVA), foveal thickness (FT) and foveal zone thickness (FZT) measured by Stratus® optical coherence tomography (OCT) were evaluated at baseline, 1, 3, 6 and 12 months after treatment. Results: Patients assigned to ketorolac had a baseline BCVA of 0.37 ± 0.17 logMAR which improved at the end of 1 year to 0.28 ± 0.16 (p = 0.02). Three eyes (20%) of 2 patients improved by 7 letters or more. Mean FT and FZT did not change significantly during the study follow-up. After 1 year of treatment, 4 eyes (27%) of 3 patients showed an improvement of at least 16% of FT and 11% of FZT. Patients assigned to dorzolamide had a baseline BCVA of 0.48 ± 0.34 logMAR which improved in the first 6 months (0.40 ± 0.30; p = 0.01), with a decrease at 1 year (0.42 ± 0.27; p = 0.20). Seven eyes (54%) of 5 patients had an improvement of 7 letters or more. Mean FT and FZT did not change significantly either. After 1 year of treatment, 3 eyes (23%) of 2 patients showed an improvement of at least 16% on FT and 11% on FZT. Conclusions: Results suggest that dorzolamide and ketorolac might improve visual acuity and therefore be of interest in selected cases. No relationship between retinal thickness fluctuation and visual acuity was found. Sample size was a limitation to the study.

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The clinical efficacy of a topical dorzolamide in the management of cystoid macular edema in patients with retinitis pigmentosa

Abstract: The results demonstrated that a topical dorzolamide is effective for the treatment of CME in patients with RP, and that the positive treatment effects last for up to 6 months.

Cited by 58 publications

References 21 publications

Resolution of macular oedema associated with retinitis pigmentosa after intravitreal use of autologous BM-derived hematopoietic stem cell transplantation

Resolution of macular oedema associated with retinitis pigmentosa after intravitreal use of autologous BM-derived hematopoietic stem cell transplantation

Intravitreal Pharmacotherapy in the Treatment of Retinitis Pigmentosa-related Cystoid Macular Oedema

Comparison of Topical Dorzolamide and Ketorolac Treatment for Cystoid Macular Edema in Retinitis Pigmentosa and Usher's Syndrome

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