Monitoring cystoid macular edema by optical coherence tomography in patients with retinitis pigmentosa

Ophthalmology. 2004 Oct;111(10):1899-904. doi: 10.1016/j.ophtha.2004.04.019.

Abstract

Purpose: To determine the value of optical coherence tomography (OCT) imaging in the diagnosis and monitoring of cystoid macular edema (CME) in patients with retinitis pigmentosa (RP).

Design: Prospective, noncomparative, small case series.

Participants: Three patients with RP and cystic-appearing spaces in the macula on OCT images.

Intervention: All 3 patients were treated with a carbonic anhydrase inhibitor, and 1 also received topical and systemic steroids.

Main outcome measures: Changes in OCT images, fluorescein angiography, and best-corrected visual acuity (VA).

Results: Although foveal cysticlike spaces were evident on OCT images in all 3 patients, only 1 patient showed CME on fluorescein angiography at baseline. Two of the 3 patients showed funduscopic evidence of macular cystic lesions, whereas a third showed no clinically evident fundus changes in the macula. Optical coherence tomography images documented improvement in the cystic-appearing spaces after treatment with the carbonic anhydrase inhibitor. Changes on fluorescein angiography were either not apparent or considerably less apparent. An improvement of > or =1 line on a Snellen acuity chart was recorded in 2 patients, whereas a third showed no change of VA in either eye.

Conclusions: Optical coherence tomography is a potential method for the diagnosis and monitoring of CME in patients with RP. It was more sensitive in this regard than either fluorescein angiography or funduscopic examination.

Publication types

  • Case Reports
  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Carbonic Anhydrase Inhibitors / therapeutic use
  • Combined Modality Therapy
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / therapeutic use
  • Humans
  • Macular Edema / diagnosis*
  • Macular Edema / drug therapy
  • Male
  • Middle Aged
  • Prospective Studies
  • Retinitis Pigmentosa / diagnosis*
  • Retinitis Pigmentosa / drug therapy
  • Tomography, Optical Coherence / methods*
  • Visual Acuity

Substances

  • Carbonic Anhydrase Inhibitors
  • Glucocorticoids