Giusti C, Forte R, Vingolo E M, Gargiulo P
University La Sapienza , Rome, Italy.
Int Ophthalmol. 2001;24(2):79-88. doi: 10.1023/a:1016354517304.
To investigate whether acetazolamide, already found to be helpful in decreasing cystoid macular edema in patients with retinitis pigmentosa, was also effective in the treatment of diabetic macular edema in nonproliferative retinopathy.
Two randomized age- and sex-matched groups (cases and controls) of 12 diabetics (five Type 1 and seven Type 2) were selected for this pilot study and graded for retinopathy (Early Treatment of Diabetic Retinopathy Study-Airlie House Classification). Cases were treated with acetazolamide for three months according to a standard protocol. The Early Treatment of Diabetic Retinopathy Study chart was used for assessing far-best corrected visual-acuity, and fluorescein angiography was performed using the Heidelberg Retina Angiograph. The Amsler grid-test and computerized-perimetry (Octopus 2000R) were also performed.
Fluorescein-angiographic findings and perimetric data improved significantly (p < 0.01) in the acetazolamide-treated cases compared to the controls while visual-acuity varied only slightly (p > 0.01). The Amsler grid-test resulted insignificant in our study (p > 0.05). No adverse effects or significant variations in laboratory tests were recorded.
Further clinical investigations involving larger numbers of patients and a longer follow-up are required to confirm these preliminary results. However, the present study seems to suggest that acetazolamide could be effective in reducing fluorescein-angiographic findings and improving perimetric data in diabetics with macular edema, even though the mechanism of action remains obscure. Visual-acuity varied only slightly.
研究已发现对色素性视网膜炎患者减轻黄斑囊样水肿有帮助的乙酰唑胺，对非增殖性视网膜病变的糖尿病性黄斑水肿治疗是否也有效。
选取两组年龄和性别匹配的12名糖尿病患者（5名1型和7名2型）进行这项初步研究，并根据糖尿病视网膜病变早期治疗研究-艾丽屋分类法对视网膜病变进行分级。病例组按照标准方案用乙酰唑胺治疗三个月。使用糖尿病视网膜病变早期治疗研究图表评估最佳矫正远视力，并使用海德堡视网膜血管造影仪进行荧光素血管造影。还进行了阿姆斯勒方格表测试和电脑视野检查（Octopus 2000R）。
与对照组相比，乙酰唑胺治疗的病例组荧光素血管造影结果和视野数据有显著改善（p < 0.01），而视力仅有轻微变化（p > 0.01）。在我们的研究中，阿姆斯勒方格表测试结果无显著意义（p > 0.05）。未记录到不良反应或实验室检查的显著变化。
需要进行涉及更多患者和更长随访时间的进一步临床研究来证实这些初步结果。然而，本研究似乎表明，乙酰唑胺可能对减轻糖尿病性黄斑水肿患者的荧光素血管造影结果和改善视野数据有效，尽管其作用机制仍不清楚。视力仅有轻微变化。
