Treatment of Cystoid Macular Edema in Retinitis Pigmentosa With Intravitreal Triamcinolone

Scorolli, L.; Morara, Mariachiara; Meduri, Alessandro; Reggiani, Maria Letizia Bacchi; Ferreri, Giuseppe; Scalinci, Sergio Zaccaria; Meduri, R.

doi:10.1001/archopht.125.6.759

Cited by 62 publications

(30 citation statements)

References 43 publications

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“…These include laser and surgical interventions, intravitreal steroid injections, systemic corticosteroids, and both topical and oral CAI. [8][9][10][11][12][13] Since treatment options are available, it is of a significant value to determine the presence of CME so that treatment can be implemented in certain patients who may benefit from its use.…”

Section: Discussionmentioning

confidence: 99%

“…Further, identifying the presence of macular cysts will additionally serve to identify those RP patients who might benefit from the use of carbonic anhydrase inhibitors (CAI) or intravitreal steroid injections to reduce the degree of macular oedema and possibly improve central visual acuity. [8][9][10][11][12][13] To our knowledge, the prevalence of subclinical macular oedema or cystic changes in the macula of RP patients has not been well defined. The presence of CME in RP patients cannot always be detected clinically with contact lens biomicroscopy or direct ophthalmoscopy.…”

Section: Introductionmentioning

confidence: 99%

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The prevalence of cystoid macular oedema on optical coherence tomography in retinitis pigmentosa patients without cystic changes on fundus examination

Hajali

Fishman

2008

Eye

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Purpose To determine the prevalence of cystoid macular oedema (CME) by optical coherence tomography (OCT) in retinitis pigmentosa (RP) patients with no evidence of cystic macular lesions on fundus examination. Methods We included 63 RP patients with no evidence of cystic-appearing macular changes on fundus examination. All patients underwent a complete ocular examination including best-corrected visual acuity using an ETDRS (Early Treatment Diabetic Retinopathy Study) chart, intraocular pressure measurement, anterior segment examination, and a detailed fundus examination. On 50 of the 63 patients, Fourier-domain OCT was performed using the radial slicer protocol. An additional 13 of the 63 patients were scanned using the macular thickness protocol on a time-domain OCT unit. The diagnosis of CME was defined by the presence of hyporeflective lacunae with well-defined boundaries on at least two of the scans. Results The mean age of patients included in the study was 36 years (range 9-71 years). Out of the 63 patients examined, 20 showed CME in at least one eye (32%), whereas 11 patients showed CME in both eyes (18%). Conclusions Our findings demonstrate that a substantial number of RP patients with CME, as determined by OCT, may not show cystic changes by direct ophthalmoscopy or contact lens biomicroscopy. Knowledge of the high frequency for CME in such patients can serve to identify those who may be amenable to current or future treatment strategies of their macular oedema and can potentially impact on future therapeutic trials where visual acuity is used as an outcome measure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The prevalence of cystoid macular oedema on optical coherence tomography in retinitis pigmentosa patients without cystic changes on fundus examination

Hajali

Fishman

2008

Eye

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“…Several therapies are used to treat CME in RP patients and include topical or oral administration of carbonic anhydrase inhibitor, [1][2][3][4] periocular or intravitreal injection of steroid, [5][6][7][8][9] intravitreal injection of bevacizumab, 10 photocoagulation, 11,12 or vitrectomy. 13 Although each of these therapeutic measures provides a benefit for some of the patients, there is little information on the pathophysiology, prevalence, or natural course of CME that is associated with RP.…”

Section: Introductionmentioning

confidence: 99%

Photoreceptor integrity and visual acuity in cystoid macular oedema associated with retinitis pigmentosa

Oishi

Otani

Sasahara

et al. 2008

Eye

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Aims To assess the correlation between macular morphology and visual acuity in retinitis pigmentosa (RP) patients with cystoid macular oedema (CME). Design Retrospective cross-sectional study. Patients and methods Forty-one eyes of 25 RP patients with CME. Patients underwent cross-sectional scans with optical coherence tomography (Stratus OCT). Age, total retinal thickness, photoreceptor thickness, and the transverse and vertical lengths of the cystoid space were measured. Correlation between visual acuity and each of the measurements were examined. Additionally, the status of the inner segment/outer segment junction (IS/OS) was classified as being absent, discontinuous, or distinct. Measurements were then compared among the three groups. Results Total retinal thickness or photoreceptor thickness was not correlated with visual acuity. There was a correlation between the transverse length of the cystoid space and visual acuity, although the correlation coefficient was weak (r ¼ 0.30). The logMAR visual acuity in the IS/OS absent group (0.67±0.43) was worse than that seen in the IS/OS discontinuous (0.22 ± 0.19) or IS/OS distinct groups (0.07 ± 0.16) (Po0.001). Conclusions When monitoring CME associated with RP, the status of IS/OS is the essential parameter that needs to be examined.

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“…The previous reports on intravitreal steroid administration in eyes with RP-related CME [30][31][32][33][34][35][36][37][38][39] are summarised in Table 1. The treatment effect of dexamethasone implant can be seen in a case with bilateral RP-related CME (Figures 1 and 2).…”

Section: -30mentioning

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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Treatment of Cystoid Macular Edema in Retinitis Pigmentosa With Intravitreal Triamcinolone

Cited by 62 publications

References 43 publications

The prevalence of cystoid macular oedema on optical coherence tomography in retinitis pigmentosa patients without cystic changes on fundus examination

The prevalence of cystoid macular oedema on optical coherence tomography in retinitis pigmentosa patients without cystic changes on fundus examination

Photoreceptor integrity and visual acuity in cystoid macular oedema associated with retinitis pigmentosa

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

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