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Yasuhiro Ikeda, Noriko Yoshida, Shoji Notomi, Yusuke Murakami, Toshio Hisatomi, Hiroshi Enaida, Tatsuro Ishibashi; Therapeutic Effect of Prolonged Treatment with Topical Dorzolamide for Cystoid Macular Edema in Patients with Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2013;54(15):671.
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To evaluate the therapeutic effect of long-term treatment with topical dorzolamide (a carbonic anhydrase inhibitor) for cystoid macular edema (CME) associated with retinitis pigmentosa (RP).
Eighteen eyes in 10 patients with CME secondary to typical forms of RP were included. Baseline visual acuity, visual field, and optical coherence tomography (OCT) measurements were obtained for all patients. All patients used 1% dorzolamide three times daily in each affected eye. Patients underwent follow-up exams at 1, 3, 6, 12, and 18 months after treatment. The response to treatment was monitored by visual acuity and visual field measurement testing using the Humphrey Field Analyzer (HFA: the central 10-2 Program); in addition, foveal thickness was measured by OCT. Evaluation of “macular sensitivity” was calculated by HFA as the average of twelve central points.
At the end of the observation period, the “macular sensitivity” in 10 eyes (55.6%) in which CME was almost completely resolved was significantly improved (p<0.05). In eight (88.9%) of the 9 eyes in which CME was almost completely resolved within 6 months, the therapeutic efficacy persisted through 18 months. Six eyes (33.3%) showed an initial response and a subsequent rebound of CME. Two eyes showed no response. No severe side effects were observed.
The prolonged use of topical dorzolamide is effective and safe for the treatment of CME in patients with RP. Therefore, we propose topical dorzolamide as a first-line treatment.
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