Abstract
Purpose: :
To assess visual acuity outcomes and macular thickness change by optical coherence tomography (OCT) in patients with macular edema secondary to a vascular etiology treated with topical Nepafenac.Methodology: The authors measured macular thickness and visual acuity in 13 eyes with two etiologies of macular edema (e.g. diabetic (6 eyes), retinal vascular occlusions (7 eyes)) using OCT technology, and Snellen chart. The patients were treated with Nepafenac 0.1%, 3 times a day, and followed up for 1 year in intervals of three months.
Results: :
At three months follow-up visual acuity improved in ten of thirteen eyes (77 % of eyes) with an average improvement of 3 lines. Seven out of eight eyes with diabetic macular edema (87.5%) and three of the five vascular occlusion eyes (60%) showed Va improvement. At six and 12 months follow-up, all 10 eyes maintained Va improvement with three eyes showing further improvement of Va from the three month follow-up. At 12 months, eyes with macular edema, showed a mean visual acuity improvement of 4 lines. Eyes with diabetic macular edema had a mean improvement of Va of 5 lines and eyes with vascular occlusions had a mean improvement of 2 lines at the 12 month follow-up.A mean improvement of 208 microns in macular thickness by OCT was observed at twelve months. The diabetic macular edema eyes showed an average improvement of 258 microns (P=0.0067) and the vascular occlusion group had a mean improvement of 37 microns (p=0.19).
Conclusions: :
Results of this study suggest that patients with macular edema treated with topical Nepafenac, showed statistically significant improvement (P = 0.0030) regarding macular thickness (208 microns) and visual acuity (77% of eyes). Eyes with diabetic macular edema appear to show a greater response to Nepafenac than eyes with edema secondary to vascular occlusions. Nepafenac may be a useful adjunct in the management of macular edema secondary to diabetic retinopathy and vascular occlusions. Prospective, randomized studies are warranted to further access the efficacy of this medication.
Keywords: macula/fovea • diabetic retinopathy • vascular occlusion/vascular occlusive disease