Skip to main content

Advertisement

Log in

The clinical efficacy of a topical dorzolamide in the management of cystoid macular edema in patients with retinitis pigmentosa

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

Cystoid macular edema (CME) is one of the common complications of retinitis pigmentosa (RP), and is responsible for patient complications such as blurred and reduced visual acuity and for subsequent atrophic changes in the fovea. The objective of this work was to evaluate the clinical efficacy of a topical dorzolamide (a carbonic anhydrase inhibitor) in CME associated with RP.

Methods

Sixteen eyes of nine patients with CME secondary to typical forms of RP were included in the study. Baseline visual acuity, visual field, and optical coherence tomography (OCT) measurements were obtained for all patients. All patients used 1% dorzolamide three times daily in each eye. Patients underwent follow-up exams at 1, 3, and 6 months after treatment. The response to treatment was monitored by visual acuity and visual field measurement testing using the Humphrey Field Analyzer (HFA: the central 10-2 Program); in addition, foveal thickness was measured by OCT. Evaluation of macular sensitivity calculated by HFA as the average of 12 central points.

Results

Thirteen (81.3%) of 16 eyes showed a clear decrease in retinal thickness after treatment. Evaluation of macular sensitivity, calculated by HFA as the average of 12 central points (with the exception of foveal point data, showed an improvement of more than 1.0 dB in nine (56.3%) of 16 eyes. Moreover, both the mean deviation value and macular sensitivity were significantly improved. No severe side-effects were seen in any of the patients examined.

Conclusions

The results demonstrated that a topical dorzolamide is effective for the treatment of CME in patients with RP, and that the positive treatment effects last for up to 6 months.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Pruett RC (1983) Retinitis pigmentosa: clinical observations and correlations. Trans Am Ophthalmol Soc 81:693–735

    PubMed  CAS  Google Scholar 

  2. Berson EL (1993) Retinitis pigmentosa. The Friedenwald lecture. Invest Ophthalmol Vis Sci 34:1659–1676

    PubMed  CAS  Google Scholar 

  3. Grover S, Fishman GA, Anderson RJ, Alexander KR, Derlacki DJ (1997) Rate of visual field loss in retinitis pigmentosa. Ophthalmology 104:460–465

    PubMed  CAS  Google Scholar 

  4. Fishman GA, Maggiano JM, Fishman M (1977) Foveal lesions seen in retinitis pigmentosa. Arch Ophthalmol 95:1993–1996

    Article  PubMed  CAS  Google Scholar 

  5. Hirakawa H, Iijima H, Gohdo T, Tsukahara S (1999) Optical coherence tomography of cystoid macular edema associated with retinitis pigmentosa. Am J Ophthalmol 128:185–191

    Article  PubMed  CAS  Google Scholar 

  6. Hajali M, Fishman GA, Anderson RJ (2008) The prevalence of cystoid macular oedema in retinitis pigmentosa patients determined by optical coherence tomography. Br J Ophthalmol 92:1065–1068

    Article  PubMed  CAS  Google Scholar 

  7. Sandberg MA, Brockhurst RJ, Gaudio AR, Berson EL (2005) The association between visual acuity and central retinal thickness in retinitis pigmentosa. Invest Ophthalmol Vis Sci 46:3349–3354

    Article  PubMed  Google Scholar 

  8. Sandberg MA, Brockhurst RJ, Gaudio AR, Berson EL (2008) Visual acuity is related to parafoveal retinal thickness in patients with retinitis pigmentosa and macular cysts. Invest Ophthalmol Vis Sci 49:4568–7452

    Article  PubMed  Google Scholar 

  9. Cox SN, Hay E, Bird AC (1988) Treatment of chronic macular edema with acetazolamide. Arch Ophthalmol 106:1190–1195

    Article  PubMed  CAS  Google Scholar 

  10. Fishman GA, Gilbert LD, Fiscella RG, Kimura AE, Jampol LM (1989) Acetazolamide for treatment of chronic macular edema in retinitis pigmentosa. Arch Ophthalmol 107:1445–1452

    Article  PubMed  CAS  Google Scholar 

  11. Ozdemir H, Karacorlu M, Karacorlu S (2005) Intravitreal triamcinolone acetonide for treatment of cystoid macular oedema in patients with retinitis pigmentosa. Acta Ophthalmol Scand 83:248–251

    Article  PubMed  Google Scholar 

  12. García-Arumí J, Martinez V, Sararols L, Corcostegui B (2003) Vitreoretinal surgery for cystoid macular edema associated with retinitis pigmentosa. Ophthalmology 110:1164–1169

    Article  PubMed  Google Scholar 

  13. Grover S, Apushkin MA, Fishman GA (2006) Topical dorzolamide for the treatment of cystoid macular edema in patients with retinitis pigmentosa. Am J Ophthalmol 141:850–858

    Article  PubMed  CAS  Google Scholar 

  14. Fishman GA, Apushkin MA (2007) Continued use of dorzolamide for the treatment of cystoid macular oedema in patients with retinitis pigmentosa. Br J Ophthalmol 91:743–745

    Article  PubMed  Google Scholar 

  15. Ito Y, Terasaki H, Takahashi A, Yamakoshi T, Kondo M, Nakamura M (2005) Dissociated optic nerve fiber layer appearance after internal limiting membrane peeling for idiopathic macular holes. Ophthalmology 112:1415–1420

    Article  PubMed  Google Scholar 

  16. Heckenlively JR, Jordan BL, Aptsiauri N (1999) Association of antiretinal antibodies and cystoid macular edema in patients with retinitis pigmentosa. Am J Ophthalmol 127:565–573

    Article  PubMed  CAS  Google Scholar 

  17. Vinores SA, Küchle M, Derevjanik NL, Henderer JD, Mahlow J, Green WR, Campochiaro PA (1995) Blood–retinal barrier breakdown in retinitis pigmentosa: light and electron microscopic immunolocalization. Histol Histopathol 10:913–923

    PubMed  CAS  Google Scholar 

  18. Wolfensberger TJ (1999) The role of carbonic anhydrase inhibitors in the management of macular edema. Doc Ophthalmol 97:387–397

    Article  PubMed  CAS  Google Scholar 

  19. Moldow B, Sander B, Larsen M, Engler C, Li B, Rosenberg T, Lund-Andersen H (1998) The effect of acetazolamide on passive and active transport of fluorescein across the blood–retina barrier in retinitis pigmentosa complicated by macular oedema. Graefes Arch Clin Exp Ophthalmol 236:881–889

    Article  PubMed  CAS  Google Scholar 

  20. Moldow B, Sander B, Larsen M, Lund-Andersen H (1999) Effects of acetazolamide on passive and active transport of fluorescein across the normal BRB. Invest Ophthalmol Vis Sci 40:1770–1775

    PubMed  CAS  Google Scholar 

  21. Apushkin MA, Fishman GA, Grover S, Janowicz MJ (2007) Rebound of cystoid macular edema with continued use of acetazolamide in patients with retinitis pigmentosa. Retina 27:1112–1128

    Article  PubMed  Google Scholar 

  22. Cheeks L, Green K (1986) Distribution of a steroid antagonist in the eye following topical administration. Curr Eye Res 5:705–709

    Article  PubMed  CAS  Google Scholar 

  23. Conroy CW (1997) Sulfonamides do not reach the retina in therapeutic amounts after topical application to the cornea. J Ocul Pharmacol Ther 13:465–472

    Article  PubMed  CAS  Google Scholar 

  24. Mizuno K, Koide T, Saito N, Fujii M, Nagahara M, Tomidokoro A, Tamaki Y, Araie M (2002) Topical nipradilol: effects on optic nerve head circulation in humans and periocular distribution in monkeys. Invest Ophthalmol Vis Sci 43:3243–3250

    PubMed  Google Scholar 

  25. Chung H, Hwang JU, Kim JG, Yoon YH (2006) Optical coherence tomography in the diagnosis and monitoring of cystoid macular edema in patients with retinitis pigmentosa. Retina 26:922–927

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

KN International provided language assistance. This work was supported in part by a Grant-in-Aid (to YI) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology (#20791259). None of the authors has any financial interests to disclose.

Competing interests

None

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yasuhiro Ikeda.

Additional information

This work was supported in part by a Grant-in-Aid (to YI) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology (#20791259).

Clinical Trial Registration: UMIN000005852 (http://www.umin.ac.jp)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ikeda, Y., Hisatomi, T., Yoshida, N. et al. The clinical efficacy of a topical dorzolamide in the management of cystoid macular edema in patients with retinitis pigmentosa. Graefes Arch Clin Exp Ophthalmol 250, 809–814 (2012). https://doi.org/10.1007/s00417-011-1904-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-011-1904-5

Keywords

Navigation