Genead Mohamed A, Fishman Gerald A
Department of Ophthalmology and Visual Sciences, Eye and Ear Infirmary, Chicago, IL 60612-7234, USA.
Arch Ophthalmol. 2010 Sep;128(9):1146-50. doi: 10.1001/archophthalmol.2010.172.
To determine the efficacy of sustained topical therapy with dorzolamide hydrochloride, 2%, on visual acuity and cystic macular lesions in patients with retinitis pigmentosa and Usher syndrome.
In a retrospective case series at a university hospital, 64 eyes of 32 patients with retinitis pigmentosa or Usher syndrome receiving treatment with the topical dorzolamide formulation for 6 to 58 months were enrolled. Changes in visual acuity on the Early Treatment Diabetic Retinopathy Study chart and central foveal zone thickness on optical coherence tomography were measured during follow-up for the duration of treatment.
Among the study cohort, 20 of 32 patients (63%) showed a positive response to treatment in at least 1 eye and 13 patients (41%) showed a positive response in both eyes. Four patients (20%) showed an initial response and a subsequent rebound of macular cysts. In 8 patients (25%), there was no response to treatment and the macular cysts worsened when compared with the pretreatment level. Ten patients (31%) had improvement in visual acuity by 7 or more letters in at least 1 eye at the most recent follow-up visit. Sixteen patients (67%) showed a reduction of more than 11% in the central foveal zone thickness in at least 1 eye when compared with the pretreatment level.
Patients with either retinitis pigmentosa or Usher syndrome who received treatment of cystoid macular edema with topical dorzolamide followed by an optical coherence tomography-guided strategy showed a decrease in central foveal zone thickness in most cases. Visual acuity improved in almost one-third of the cases, suggesting a potential corresponding visual benefit.
确定2%盐酸多佐胺持续局部治疗对色素性视网膜炎和Usher综合征患者视力及黄斑囊性病变的疗效。
在一所大学医院进行的一项回顾性病例系列研究中，纳入了32例接受局部多佐胺制剂治疗6至58个月的色素性视网膜炎或Usher综合征患者的64只眼。在治疗期间的随访中，测量早期糖尿病视网膜病变研究图表上的视力变化以及光学相干断层扫描上的中央凹区厚度。
在研究队列中，32例患者中有20例（63%）至少一只眼对治疗有阳性反应，13例患者（41%）双眼有阳性反应。4例患者（20%）出现黄斑囊肿的初始反应及随后的反弹。8例患者（25%）对治疗无反应，与治疗前水平相比黄斑囊肿恶化。10例患者（31%）在最近一次随访时至少一只眼的视力提高了7个或更多字母。16例患者（67%）与治疗前水平相比，至少一只眼的中央凹区厚度减少超过11%。
接受局部多佐胺治疗黄斑囊样水肿并采用光学相干断层扫描引导策略的色素性视网膜炎或Usher综合征患者，多数情况下中央凹区厚度减小。近三分之一的病例视力有所改善，提示可能有相应的视力获益。
