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S. Yzer, T. Missotten, J. P. Martinez Ciriano, T. L. J. M. van de Loos, G. S. Baarsma, P. M. van Hagen, L. I. van den Born; The Effect of Somatostatin Analogs on Cystoid Maculopathy in Patients with Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1001.
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© ARVO (1962-2015); The Authors (2016-present)
Somatostatin analogs have proved to be beneficial in the treatment of retinal diseases complicated by cystoid macular edema, probably due to the positive effect on apical-basal direction oriented fluid transport in the retinal pigment epithelium. We studied the effect of the somatostatin analog Octreotide long acting repeatable (LAR) on cystoid maculopathy in patients with retinitis pigmentosa (RP).
Thirty-four eyes of 17 patients (10 isolated RP, 4 autosomal dominant RP, 1 autosomal recessive RP, 2 Usher syndrome) were included after treatment with acetazolomide had failed, either due to side effects or lack of visual improvement. Patients were treated with monthly intramuscular injections with 20mg Octreotide LAR. Evaluation consisted of Best Corrected Visual Acuity (BCVA) and optical coherence tomography (OCT), performed before and after three injections, and onwards. When BCVA improved and the cysts on OCT decreased treatment was continued.
Treatment duration varied from 3 to 72 months (mean 17,7 months). Eighteen eyes (10 patients) showed improvement of BCVA and reduction of cystoid maculopathy. In 16 eyes (9 patients) no positive effect on BVCA was detected. Four patients are still being treated. Intramuscular injections were discontinued in 14 patients because of long lasting stabilised improvement (3 patients), pregnancy (2 patients), absence of improvement (5 patients) or because of side effects (3 patients).
This study suggests that Octreotide LAR injections maybe useful in the treatment of a subset of RP patients with cystoid maculopathy.
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