Efficacy of Topical Betaxolol for Persistent Macular Edema

Abstract

Abstract: : Purpose: To report the efficacy and safety of topical betaxolol for treatment of persistent macular edema. Methods: In this prospective randomized trial, Thirty-seven eyes (37 patients) with best-corrected visual acuity between 20/200 and 20/50 and macular edema which remained for three months after vitrectomy and removal of epiretinal membrane were prospectively randomized to receive betaxolol or placebo. Nineteen eyes of 19 patients received betaxolol twice daily and 18 eyes of 18 patients were received placebo as a randomized comparison group. The patients were followed-up for 6 months. This study evaluated the effect of betaxolol on best-corrected visual acuity and area of macular edema, which was digitally measured on serial fluorescein angiogram. To assess changes of area of edema, the initial (pretreatment) size of the edema was set to 100%, and all posttreatment measurements were normalized relative to the initial size. Results: Mean best-corrected visual acuity at baseline was 0.216 (20/92.6) and 0.244 (20/82.0) in the treatment and control group, respectively. Mean area of macular edema was 2.271 ± 1.629 mm² and 2.273 ± 1.209 mm² in the treatment and control group; there was no significant difference. The visual acuity at 6 months after the start of the follow-up was 0.471 (20/42.5) in the treatment group and 0.236 (20/84.7) in the control group. Mean changes in log of minimal angle resolution (LogMAR) of visual acuity for 3- and 6-month follow-up were -0.282 ± 0.191 and -0.337 ± 0.197 in the treatment group, and -0.016 ± 0.186 and +0.015 ± 0.267 in the control group; a significant difference was found (P < 0.0001; P < 0.0001). Areas of macular edema at 6 months after the start of the follow-up were 1.492 ± 1.357 mm² in the treatment group and 2.125 ± 1.434 mm² in the control group. Mean change of area of the edema for 6 months were 76.5 ± 24.1% and 63.4 ± 28.3% in the treatment group and 92.9 ± 15.4% and 87.4 ± 25.6% in the control group; treated patients showed a significantly larger reduction than untreated patients at each examination (P = 0.0193; P = 0.102). Conclusions: Topical betaxolol appeared to have a favorable treatment effect in eyes with macular edema which remained after vitrectomy and removal of epiretinal membrane. Further investigation on more cases and longer follow-up are needed.

Keywords: clinical (human) or epidemiologic studies: tre • drug toxicity/drug effects • macula/fovea