Efficacy and Prognostic Factors of Response to Carbonic Anhydrase Inhibitors in Management of Cystoid Macular Edema in Retinitis Pigmentosa
Efficacy and Prognostic Factors of Response to Carbonic Anhydrase Inhibitors in Management of Cystoid Macular Edema in Retinitis Pigmentosa
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DOI：
10.1167/iovs.14-15995
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发表时间：
2015-03-01
影响因子：
4.4
通讯作者：
Michaelides, Michel
中科院分区：
文献类型：
--
作者：
Liew, Gerald;Moore, Anthony T.;Michaelides, Michel
目的。确定碳酸酐酶抑制剂 (CAI) 治疗色素性视网膜炎 (RP) 黄斑囊样水肿 (CME) 的疗效和预后因素。方法。这是一项对 81 名受试者进行的队列研究，他们在治疗前后进行了评估。谱域光学相干断层扫描 (SD-OCT) 用于量化 CME。中央子区域 (CSF) 厚度至少减少 11% 被定义为缓解的客观证据。 结果。在接受局部多佐胺治疗的 125 只眼睛中，40.0% 的眼睛表现出治疗反应，OCT CSF 厚度平均减少 105 lm（95% 置信区间 [CI]：82, 128）。中位治疗时间为 3.0 个月后，平均起始视力 (VA) 从 6/15 增加至 6/12。在接受口服乙酰唑胺治疗的患者中，28.1% 的眼睛（41.2% 的患者）在中位治疗间隔 4.0 个月的时间里，平均 OCT CSF 厚度改善为 115 lm (95% CI: 52, 177)。视力从 6/15 提高到 6/12。对局部多佐胺有反应的眼睛比常染色体显性 RP 更有可能患有常染色体隐性遗传（44.6% vs. 23.3%，P = 0.02），并且比没有反应的眼睛具有更高的平均基线 OCT CSF（P = 0.02）。结论。我们报告称，在局部多佐胺治疗后，40.0% 的眼睛（53.1% 的患者）的 CME 表现出客观改善，而在口服乙酰唑胺治疗后，28.1% 的眼睛（41.2% 的患者）出现 CME 客观改善。常染色体隐性 RP 和较大的初始中央视网膜厚度预示着对局部多佐胺治疗的反应。
PURPOSE. To determine the efficacy and prognostic factors associated with carbonic anhydrase inhibitors (CAI) in the treatment of cystoid macular edema (CME) in retinitis pigmentosa (RP).METHODS. This was a cohort study of 81 subjects who were assessed before and after treatment. Spectral-domain optical coherence tomography (SD-OCT) was used to quantify CME. A reduction of at least 11% in central subfield (CSF) thickness was defined as objective evidence of response.RESULTS. In the 125 eyes that received topical dorzolamide, 40.0% demonstrated a response to treatment with a mean reduction in OCT CSF thickness of 105 lm (95% confidence interval [CI]: 82, 128). Mean starting visual acuity (VA) increased from 6/15 to 6/12 after a median time on treatment of 3.0 months. In patients prescribed oral acetazolamide, 28.1% of eyes (41.2% of patients) showed improvement in mean OCT CSF thickness of 115 lm (95% CI: 52, 177) over a median treatment interval of 4.0 months. Visual acuity improved from 6/15 to 6/12. Eyes that responded to topical dorzolamide were more likely to have autosomal recessive than autosomal dominant RP (44.6% vs. 23.3%, P = 0.02), and a higher mean baseline OCT CSF than eyes that did not respond (P = 0.02).CONCLUSIONS. We report that 40.0% of eyes (53.1% of patients) showed an objective improvement in CME after treatment with topical dorzolamide and 28.1% of eyes (41.2% of patients) after treatment with oral acetazolamide. Autosomal recessive RP and greater initial central retinal thickness predicted response to treatment with topical dorzolamide.