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Efficacy and prognostic factors of response to carbonic anhydrase inhibitors in management of cystoid macular edema in retinitis pigmentosa.

AbstractPURPOSE:
To determine the efficacy and prognostic factors associated with carbonic anhydrase inhibitors (CAI) in the treatment of cystoid macular edema (CME) in retinitis pigmentosa (RP).
METHODS:
This was a cohort study of 81 subjects who were assessed before and after treatment. Spectral-domain optical coherence tomography (SD-OCT) was used to quantify CME. A reduction of at least 11% in central subfield (CSF) thickness was defined as objective evidence of response.
RESULTS:
In the 125 eyes that received topical dorzolamide, 40.0% demonstrated a response to treatment with a mean reduction in OCT CSF thickness of 105 μm (95% confidence interval [CI]: 82, 128). Mean starting visual acuity (VA) increased from 6/15 to 6/12 after a median time on treatment of 3.0 months. In patients prescribed oral acetazolamide, 28.1% of eyes (41.2% of patients) showed improvement in mean OCT CSF thickness of 115 μm (95% CI: 52, 177) over a median treatment interval of 4.0 months. Visual acuity improved from 6/15 to 6/12. Eyes that responded to topical dorzolamide were more likely to have autosomal recessive than autosomal dominant RP (44.6% vs. 23.3%, P = 0.02), and a higher mean baseline OCT CSF than eyes that did not respond (P = 0.02).
CONCLUSIONS:
We report that 40.0% of eyes (53.1% of patients) showed an objective improvement in CME after treatment with topical dorzolamide and 28.1% of eyes (41.2% of patients) after treatment with oral acetazolamide. Autosomal recessive RP and greater initial central retinal thickness predicted response to treatment with topical dorzolamide.
AuthorsGerald Liew, Anthony T Moore, Andrew R Webster, Michel Michaelides
JournalInvestigative ophthalmology & visual science (Invest Ophthalmol Vis Sci) Vol. 56 Issue 3 Pg. 1531-6 (Feb 10 2015) ISSN: 1552-5783 [Electronic] United States
PMID25670491 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright 2015 The Association for Research in Vision and Ophthalmology, Inc.
Chemical References
  • Carbonic Anhydrase Inhibitors
  • Delayed-Action Preparations
  • Ophthalmic Solutions
  • Sulfonamides
  • Thiophenes
  • dorzolamide
  • Acetazolamide
Topics
  • Acetazolamide (therapeutic use)
  • Administration, Oral
  • Adult
  • Carbonic Anhydrase Inhibitors (therapeutic use)
  • Cohort Studies
  • Delayed-Action Preparations
  • Drug Administration Schedule
  • Female
  • Humans
  • Macular Edema (diagnosis, drug therapy)
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Retinitis Pigmentosa (diagnosis, drug therapy)
  • Retrospective Studies
  • Sulfonamides (therapeutic use)
  • Thiophenes (therapeutic use)
  • Tomography, Optical Coherence
  • Treatment Outcome

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