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

Abstract

BACKGROUND:

Carbonic 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.

METHODS:

Databases 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.

RESULTS:

11 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.

CONCLUSION:

Based 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.

• Authors: Qinzhu Huang, Ru Chen, Xianping Lin, Zhenyang Xiang
• Journal: PloS one (PLoS One) Vol. 12 Issue 10 Pg. e0186180 ( 2017) ISSN: 1932-6203 [Electronic] United States
• PMID: 29023491 (Publication Type: Journal Article, Meta-Analysis)

Chemical References

• Carbonic Anhydrase Inhibitors
• Sulfonamides
• Thiophenes
• dorzolamide
• Acetazolamide

Topics

• Acetazolamide (administration & dosage, pharmacology)
• Administration, Oral
• Administration, Topical
• Carbonic Anhydrase Inhibitors (administration & dosage, pharmacology)
• Clinical Trials as Topic
• Female
• Humans
• Macular Edema (drug therapy)
• Male
• Prospective Studies
• Retinitis Pigmentosa (complications)
• Sulfonamides (administration & dosage, pharmacology)
• Thiophenes (administration & dosage, pharmacology)
• Treatment Outcome
• Visual Acuity (drug effects)