Abstract
Purpose: :
To study the effect of acetazolamide on cystoid macular edema (CME) in patients with Retinitis Pigmentosa (RP).
Methods: :
Twenty-six patients with CME due to RP underwent comprehensive anamnesis, best corrected visual acuity by Snellen visual chart, slit lamp biomicroscopy, fundus examination, fundus photography, Goldmann visual field, electroretinography (ERG) and optical coherence tomography (OCT). Sixteen subjects treated with oral acetazolamide and 10 control subjects underwent to follow up visits before the treatment, at 3 and 6 months. A visual improvement was considered to be a variation from baseline of > 1 line on Snellen acuity chart. A change in macular thickness exceeding 12% was regarded as significant.
Results: :
In the 31 eyes treated, central visual acuity (CVA) improved in 45% after 3 months and in 61% after 6 months of therapy. Statistical analysis revealed an improvement in CVA at 3 and 6 months (Friedman test; p= 0.0005) and a significant difference between treated and untreated patients at 3 (Fisher test; p= 0.01) and 6 months (Fisher test; p= 0.001).Moreover, central macular thickness decreased in 22% of treated eye after 3 months and 29% after 6 months of therapy.The analysis of these data did not show any variation in central macular thickness at 3 and 6 months of treatment (Friedman test; p= 0.9) and no significant difference between treated and untreated patients was observed (Fisher test; 3 month p= 1; 6 month p= 0.1).
Conclusions: :
On the basis of the positive response in treated subjects regarding above all visual acuity, the subjective improvement in vision claimed by the patients and the absence of major adverse events, it is our belief that acetazolamide treatment should be recommended for CME in patients with RP.
Keywords: edema • retinitis • macula/fovea