Treatment of cystoid macular edema with the new-generation NSAID nepafenac 0.1%

Abstract

Purpose:To describe the use of nepafenac 0.1% for cystoid macular edema (CME).Methods:This was a multicenter retrospective review of 22 CME cases (20 patients) treated with nepafenac 0.1% (six with concomitant prednisolone acetate 1%) from December 2005 to April 2008: three acute pseudophakic CME cases, 13 chronic/recalcitrant pseudophakic CME cases, and six cases of uveitic CME. Pre- and post-treatment retinal thickness and visual acuity were reported.Results:Following treatment for six weeks to six months, six eyes with uveitic CME showed a mean retinal thickness improvement of 227 ± 168.1 μm; mean best-corrected visual acuity (BCVA) improvement was 0.36 ± 0.20 logMAR. All three cases of acute pseudophakic CME improved after four to 10 weeks of nepafenac, with a mean improvement in retinal thickness of 134 ± 111.0 μm. BCVA improved in two patients (0.16 and 0.22 logMAR) but not in the third due to underlying retinal pigment epithelium changes. Thirteen eyes with chronic/recalcitrant pseudophakic CME demonstrated a mean improvement in retinal thickness of 178 ± 128.7 μm after nepafenac and mean BCVA improvement of 0.33 ± 0.19 logMAR.Conclusion:The positive outcomes of these 22 eyes strongly suggest that nepafenac 0.1% is a promising drug for the treatment of CME. Additional study under randomized controlled conditions is warranted.

Optical coherence tomography imaging in uveitis

“…Optical coherence tomography has also been used to diagnose, assess, and monitor the therapeutic response in uveitic macular edema [48,51,[69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85]. In a recent study, Sugar et al [86] tried to identify a clinically meaningful threshold for change in uveitic macular edema evaluated by OCT. A 20 % change in retinal thickness in patients with uveitic macular edema was found to be optimal for clinically important changes in visual acuity.…”

Resolution of Cystoid Macular Edema Secondary to Radiotherapy following Topical Nepafenac Treatment

“…Nepafenac has been reported to be effective against macular edema of various etiologies, including acute and chronic pseudophakic CME, uveitic CME, diabetic macular edema and postoperative CME. 4,[7][8][9] Our case demonstrated that topical nepafenac is effective in the treatment of CME secondary to radiation therapy. Following treatment, there was rapid and complete resolution of macular edema and improvement in vision.…”

“…Several studies have previously reported the beneficial effects of nepafenac in treating CME. 3,4 We hereby report the use of topical nepafenac in a patient with CME secondary to radiation therapy for choroidal metastasis. Treatment resulted in prompt reduction in CME with visual improvement.…”

Central retinal vein occlusion after coronary artery bypass surgery: A case report

“…We used low-molecular-weight-heparin (enoxaparin) in the treatment of this patient, according to the ophtalmologist's suggestions. Also, a topical non-steroidal anti-inflammatory agent (nepafenac 0.1%) was administered, to reduce macular edema until the venous occlusion resolved (6). The patient's macular edema was minimally cystoid so no other treatments were considered.…”