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A. Yee, M. Peracha, H. Gao, W. Provence; Use of Topical Nepafenac 0.1% in the Treatment of Non-Pseudophakic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2710. doi: https://doi.org/.
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Topical non-steroidal anti-inflammatory (NSAID) drops are routinely used to treat pseudophakic cystoid macular edema (CME). We wanted to assess the efficacy of topical nepafenac for treatment of non-pseudophakic CME.
Eleven patients with CME were included in this case series. Etiology of CME included diabetic retinopathy, branch and central retinal vein occlusion, retinitis pigmentosa, immune recovery uveitis, and central serous retinopathy. CME was diagnosed based on clinical exam and confirmed with optical coherence tomography (OCT). Patients were treated with topical nepafenac 0.1% ophthalmic suspension (Alcon) tid to the effected eyes. Visual acuity (VA), intraocular pressure (IOP), and OCT measurements were followed on each visit.
Mean age of patients was 52 years old, including 3 women and 8 men. Five subjects were previously treated with topical 1% prednisolone, but failed to improve. Three patients had been treated with focal grid laser and one with panretinal photocoagulation. Mean pre-treatment VA was 0.423 logMAR units (Snellen conversion ~20/50) and mean IOP was 15.4 mmHg. Mean central foveal thickness on OCT was 392 µm (165 to 505 µm). Patients were treated with topical nepafenac for an average of 70.4 days (28 to 121 days). Mean post-treatment VA was 0.276 logMAR units (Snellen conversion ~ 20/30), with an overall 14 % improvement (p = 0.0112). Mean post-treatment central foveal thickness was 299 µm (95 to 460 µm), indicating a mean reduction of 93 µm, or 22.2% (p = 0.00083). Mean post-treatment IOP was 15.5 mmHg, indicating that IOP was minimally affected during treatment. Additionally, 5 of the 11 patients showed a complete resolution of sub-retinal fluid on OCT.
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