Intravitreal ranibizumab in the treatment of cystoid macular edema associated with retinitis pigmentosa

J Ocul Pharmacol Ther. 2009 Dec;25(6):545-50. doi: 10.1089/jop.2009.0089.

Abstract

Purpose: To report and evaluate the anatomic, clinical, and visual acuity response after intravitreal ranibizumab (IVR) injection in patients with cystoid macular edema (CME) due to retinitis pigmentosa (RP).

Methods: This study included 30 eyes of 30 patients with RP who had persistent CME at least 6 months despite medication with acetazolamide. Fifteen eyes of 15 eligible patients were treated with 0.5 mg IVR injection (treatment group). Fifteen eyes of 15 patients with the same characteristics who refused treatment were accepted as control group. The primary outcome of the study (morphologic restitution) was the complete or significant resolution of cystoid space on optic coherence tomography (OCT) without relapse or complication at 6 months. The serial changes in best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were measured.

Results: Thirteen eyes (86.6%) in the treatment group had significant resolution of CME at 6 months after single IVR injection. The difference between the 2 groups in BCVA was not statistically significant (P > 0.05). The baseline mean +/- SD CFT for the treatment and control groups were 478 +/- 88 microm and 469 +/- 75 microm, respectively (P > 0.05). At 6 months after treatment, the mean +/- SD CFT of the treatment group improved to 272 +/- 65 microm whereas that in the control group was 480 +/- 92 microm (P < 0.001).

Conclusions: This investigation indicated that IVR may provide a new therapeutic approach for the treatment of CME secondary to RP. No adverse event was found to be associated with the treatment. Continued experience with IVR in this population will help establish its longer-term efficacy.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Acetazolamide / therapeutic use
  • Adult
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Carbonic Anhydrase Inhibitors / therapeutic use
  • Female
  • Follow-Up Studies
  • Fovea Centralis / pathology
  • Humans
  • Injections, Intraocular
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Male
  • Middle Aged
  • Prospective Studies
  • Ranibizumab
  • Retinitis Pigmentosa / complications*
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Visual Acuity / drug effects

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Carbonic Anhydrase Inhibitors
  • Acetazolamide
  • Ranibizumab