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E. Vingolo, P.G. Limoli, D. Domanico, R. Giustolisi, R. Grenga; Macular Edema Treatment With Oral Steroids in Retinitis Pigmentosa (RP) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):527.
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Introduction: Central vision in patients with Retinitis Pigmentosa (RP) is usually good, unless atrophic central lesions and cystoid macular edema (CME) appears, reducing vision in late RP followed by macular hole or macular atrophy, our goal will be to evaluate if is possible to treat CME in retinitis pigmentosa wit orally steroids (deflazacort DFZ). Methods: 10 patients, (age 42.7 ± 12.6 yrs) entered this study. All patients with (CME). They underwent a baseline measurement of visual acuity, complete ophthalmologic examination Humphrey Visual Field Analysis HRA FA and OCT 3 map, at the baseline 1–3–6–12 months of therapy, Treatment scheme was in one 30 mg oral DFZ tablets administered for a year; Results:Data demonstrated a significant improvement in far and near visual acuity and a reduction of fluorescein leakage on fluorescein angiography. Near BCVA changes demonstrated a significative improvement (p<0.005) at every step of the follow–up starting from 32±12 cp at the baseline to 8±2 cp at the firs control remaining quite the same, while far BCVA showed a mild increase of slight statistical significance, starting from 0,6±1,8 to 0,7±2,4 the variations in medium far and near visual acuity during the one–year treatment period with DFZ Visual field Analysis from a baseline of (14,17±4,27dB) showed an improvement of central retinal function statistically significative with peridata analysis and with average sensitivity calculation. OCT analysis demonstrated the reduction of retinal thickness in the macular region starting from 380±89µ to 240±65µ at one month 265±47µ at 3 months and 270±51µ at 6 and 268±50µ at 12 months No ocular effects were observed throughout the treatment period. Namely, no statistically significant increase in intraocular pressure was observed, neither was documented a progression of breadcrumb lens opacities over time. Conclusions: Obviously this study is a short time evaluation of steroids therapy in tapetoretinal degenerations, but our results could be a clinical suggestion to investigate steroids on macular function. Main bugs for our study are the relatively short duration of the follow up and the open design; even if the improvement obtained during the time was so stable and different from the natural history of the disease. The way for therapy of tapetoretinal degenerations is certainly different from this presented in our study, but our results derivates from a long term research that we begun in far 1991. We think that from a clinical point of view treatment with steroids could be a good chance, waiting for the cure of RP.
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